Provider Demographics
NPI:1740832187
Name:EL-KHOURY, JASMINE (DDS)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:EL-KHOURY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 ASHTON CT
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5262
Mailing Address - Country:US
Mailing Address - Phone:818-987-6477
Mailing Address - Fax:
Practice Address - Street 1:7525 ASHTON CT
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-5262
Practice Address - Country:US
Practice Address - Phone:818-987-6477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002159122300000X
CA104719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist