Ahmed Elgazar, DDS.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45853 Issued in CA

Practice address

14051 Newport Ave
B2
Tustin, CA 92780-5171

Phone

(714) 838-1199

Fax

(714) 838-1018

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elgazar DDS Inc

  • Dental Clinic/Center
  • Tustin, CA
  • NPI 1295597797
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1265580658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 NEWPORT AVE",
            "address_2": "B2",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927805171",
            "telephone_number": "714-838-1199",
            "fax_number": "714-838-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14051 NEWPORT AVE",
            "address_2": "B2",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927805171",
            "telephone_number": "714-838-1199",
            "fax_number": "714-838-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELGAZAR",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "DDS.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "B45853-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED COCORDIA",
            "identifier": "139724",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omar El Essawy
• Mohammad Adnan Elbatta
• Sharif L Elbayoumy, DDS, MS
• Devyn Eldridge
• Elgazar DDS Inc
• Marilou Dyquiangco Elido, DDS
• Ryan Elido
• Elite Physical Medicine
• Elizabeth Kim Nguyen DDS Inc
• Nan Eller, CCC-SLP

• General Practice Dentistry in Tustin, CA
• Providers in Tustin, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.