Provider Demographics
NPI:1740872266
Name:MORCOS EBIED, SHERIF (BDS, MDS, MSD, PHD)
Entity type:Individual
Prefix:
First Name:SHERIF
Middle Name:
Last Name:MORCOS EBIED
Suffix:
Gender:M
Credentials:BDS, MDS, MSD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 PORTAGE TRL # 1
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3053
Mailing Address - Country:US
Mailing Address - Phone:216-415-2005
Mailing Address - Fax:
Practice Address - Street 1:822 PORTAGE TRL STE 1
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3053
Practice Address - Country:US
Practice Address - Phone:330-929-2853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0263711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30.026371OtherOHIO DENTAL BOARD