Provider Demographics
NPI:1871164764
Name:AL-KARABSHA, SHUROUK MAJED (DDS)
Entity type:Individual
Prefix:
First Name:SHUROUK
Middle Name:MAJED
Last Name:AL-KARABSHA
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 1:162 S BRIGHTON PARK CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3053
Mailing Address - Country:US
Mailing Address - Phone:314-498-3740
Mailing Address - Fax:
Practice Address - Street 1:4121 ELM PARK DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1918
Practice Address - Country:US
Practice Address - Phone:314-845-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021024776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist