Provider Demographics
NPI:1124716931
Name:EL-DESOKY, DALIA HANY
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:HANY
Last Name:EL-DESOKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 S LOYOLA DR APT 251
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-5495
Mailing Address - Country:US
Mailing Address - Phone:504-645-9129
Mailing Address - Fax:
Practice Address - Street 1:40470 GERMANY RD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-6735
Practice Address - Country:US
Practice Address - Phone:225-622-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA74241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice