MEDICARE: DR. KARIM AHMAD SAMY EL NOKRASHY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	50906	CA

General Provider Information

NPI Number	:	1699770966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARIM AHMAD SAMY EL NOKRASHY DDS

Provider Business Mailing Address
First Line	:	5500 MARIOLYN WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95757-1625
Country	:	US
Telephone Number	:	909-709-7010
Fax Number	:	916-379-8371

Provider Business Practice Location Address
First Line	:	1503 E MARCH LN
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95210-5622
Country	:	US
Telephone Number	:	909-709-7010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	04/12/2013

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