Provider Demographics
NPI:1992917710
Name:ELNAKA, KAREEM MOHAMED (DDS)
Entity type:Individual
Prefix:MR
First Name:KAREEM
Middle Name:MOHAMED
Last Name:ELNAKA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14374 MANGROVE ST
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3546
Mailing Address - Country:US
Mailing Address - Phone:805-532-2445
Mailing Address - Fax:805-983-0596
Practice Address - Street 1:1339 DORIS AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-4409
Practice Address - Country:US
Practice Address - Phone:805-983-0593
Practice Address - Fax:805-983-0596
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46055122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice