Provider Demographics
NPI:1023746112
Name:ELSHARABASSY, NADA (DMD)
Entity type:Individual
Prefix:
First Name:NADA
Middle Name:
Last Name:ELSHARABASSY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 W SAMPLE RD APT 201
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3757
Mailing Address - Country:US
Mailing Address - Phone:954-999-9665
Mailing Address - Fax:
Practice Address - Street 1:2925 NE 199TH ST STE 309
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3109
Practice Address - Country:US
Practice Address - Phone:305-935-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27261122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist