Healthcare Provider Details

I. General information

NPI: 1790461358
Provider Name (Legal Business Name): DINA MOHAMED KAMEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 24TH ST
NEW YORK NY
10010-4020
US

IV. Provider business mailing address

6863 CHELSEA RD
MC LEAN VA
22101-2806
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-9800
  • Fax:
Mailing address:
  • Phone: 703-748-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number065081-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN2001569
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: