Provider Demographics
NPI:1154297794
Name:BEN KURA, GHAZI MAHMOUD
Entity type:Individual
Prefix:
First Name:GHAZI
Middle Name:MAHMOUD
Last Name:BEN KURA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MARION PL APT 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-6438
Mailing Address - Country:US
Mailing Address - Phone:202-012-0596
Mailing Address - Fax:
Practice Address - Street 1:16 MARION PL APT 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-6438
Practice Address - Country:US
Practice Address - Phone:202-012-0596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADENT.DE.616283881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice