Provider Demographics
NPI:1942511803
Name:JOSEPHS, ELIAS KAMAAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:KAMAAL
Last Name:JOSEPHS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 4TH ST
Mailing Address - Street 2:APT. 2-F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2866
Mailing Address - Country:US
Mailing Address - Phone:561-350-5657
Mailing Address - Fax:
Practice Address - Street 1:333 4TH ST
Practice Address - Street 2:APT. 2-F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2866
Practice Address - Country:US
Practice Address - Phone:561-350-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0566201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry