Healthcare Provider Details

I. General information

NPI: 1073325718
Provider Name (Legal Business Name): ELMAZ DZHAPAROVA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025N BRISTOL PIKE
LEVITTOWN PA
19057-4707
US

IV. Provider business mailing address

24 MAPLE AVE
CHERRY HILL NJ
08002-1942
US

V. Phone/Fax

Practice location:
  • Phone: 215-915-0505
  • Fax:
Mailing address:
  • Phone: 412-576-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS044915
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: