Provider Demographics
NPI:1720426174
Name:ELGAMAL, SHIERF MAHMOUD (DDS)
Entity Type:Individual
Prefix:
First Name:SHIERF
Middle Name:MAHMOUD
Last Name:ELGAMAL
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 1:1665 E LINCOLN AVE APT B29
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1929
Mailing Address - Country:US
Mailing Address - Phone:951-334-7721
Mailing Address - Fax:
Practice Address - Street 1:1665 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1929
Practice Address - Country:US
Practice Address - Phone:714-637-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62327122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist