Active NPI
Elnaggar DDS Inc
Doing business as St. Mark Family Dental
- Dentist
- Canoga Park, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60170
- Legal business name
- ELNAGGAR DDS INC
- Doing business as
- St. Mark Family Dental
- Practice address
- 20913 Sherman Way
Canoga Park, CA 91303-1743 - Phone
- (818) 992-4600
- Fax
- (818) 992-4602
- NPI assigned
- Jan 20, 2015
- Last updated
- Aug 5, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Maged M Elnaggar, DDS
- Title
- Dentist
- Phone
- (818) 667-8257
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60170 | CA | Primary |
Addresses
Primary practice location
20913 Sherman Way
Canoga Park, CA 91303-1743
Mailing address
20913 Sherman Way
Canoga Park, CA 91303-1743
Phone (818) 992-4600
Other names 1
- St. Mark Family Dental
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
20913 Sherman Way
Canoga Park, CA 91303
Phone (818) 992-4600
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
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- NPI 1912203100
-
- Dentist
- Las Vegas, NV
- NPI 1821681164
-
- Dentist
- Canoga Park, CA
- NPI 1285742619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596585600000",
"number": "1427447028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20913 SHERMAN WAY",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913031743",
"telephone_number": "818-992-4600",
"fax_number": "818-992-4602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20913 SHERMAN WAY",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913031743",
"telephone_number": "818-992-4600",
"fax_number": "818-992-4602"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELNAGGAR DDS INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-20",
"last_updated": "2020-08-05",
"certification_date": "2020-08-05",
"status": "A",
"authorized_official_last_name": "ELNAGGAR",
"authorized_official_first_name": "MAGED",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "818-667-8257",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "60170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Mark Family Dental",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.