Healthcare Provider Details

I. General information

NPI: 1508643909
Provider Name (Legal Business Name): ENAS ELMAGHRBI D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 SAINT ROBERT BLVD
SAINT ROBERT MO
65584-3363
US

IV. Provider business mailing address

1251 BAY RIDGE PKWY APT # 6
BROOKLYN NY
11228
US

V. Phone/Fax

Practice location:
  • Phone: 573-679-3833
  • Fax:
Mailing address:
  • Phone: 347-553-4887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2023043451
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI02997500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401418672
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: