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General NPI Number Information
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NPI Number | 1790101244
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Entity Type | Individual
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Provider Name | ANDREW ELMASRI DDS
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Gender | Male
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2 CAMBERLEY
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2942
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Country | US
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Telephone | 949-212-1543
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CAMBERLEY
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2942
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Country | US
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Telephone | 949-212-1543
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Fax |
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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 | 62252
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | GA1703
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License Number State | CA
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