Provider Demographics
NPI:1932403375
Name:OSMAN, NAWAL (DDS)
Entity Type:Individual
Prefix:
First Name:NAWAL
Middle Name:
Last Name:OSMAN
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 1:4925 CONCORDIA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5561
Mailing Address - Country:US
Mailing Address - Phone:831-917-4078
Mailing Address - Fax:
Practice Address - Street 1:2205 FRANCISCO DR STE 150
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-3943
Practice Address - Country:US
Practice Address - Phone:916-934-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 491741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice