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General NPI Number Information
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NPI Number | 1073558631
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Entity Type | Individual
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Provider Name | ASHRAF M ESTAFAN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 14 VANDERVENTER AVE SUITE 215
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3759
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Country | US
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Telephone | 516-883-6199
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Fax | 516-883-6959
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Provider Business Mailing Address
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Address Line | 14 VANDERVENTER AVE SUITE 215
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3759
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Country | US
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Telephone | 516-883-6199
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Fax | 516-883-6959
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 049384
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 049384
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License Number State | NY
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