Provider Demographics
NPI:1366540825
Name:METIAS, NAGWA GHALI (DDS)
Entity type:Individual
Prefix:DR
First Name:NAGWA
Middle Name:GHALI
Last Name:METIAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12456 VENICE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066
Mailing Address - Country:US
Mailing Address - Phone:310-390-2483
Mailing Address - Fax:310-636-4410
Practice Address - Street 1:12563 VENICE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-3712
Practice Address - Country:US
Practice Address - Phone:310-390-2483
Practice Address - Fax:310-636-4410
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD449421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice