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DR. TARIQ ELMADAWY
NPI 1164109336
Dentist in Green Bay, WI

Active since June 29, 2023
1551 PARK PL STE 300, GREEN BAY, WI 54304(920) 332-6644 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Tariq Elmadawy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TARIQ ELMADAWY (NPI 1164109336) is an individual dentist in Green Bay, Wisconsin, licensed in Michigan (2901601681) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1164109336
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. TARIQ ELMADAWY
Location Address1551 PARK PL STE 300Green Bay, WI 54304-1969
Mailing Address2480 Marina Cir Unit 502Ashwaubenon, WI 54304-4877 · (734) 502-8196
Phone(920) 332-6644
Sole ProprietorYes
Enumeration DateJune 29, 2023
Last NPPES UpdateJanuary 27, 2025
NPPES CertifiedJanuary 27, 2025
✔ NPI 1164109336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in MI · 2901601681✔ Licensed in WI · 6001237-15
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1551 PARK PL STE 300, Green Bay, WI 54304
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, Delta Dental of Michigan, Guardian and more.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HUSSAM JABER
Dentist (General Practice)
1551 PARK PL STE 300
GREEN BAY, WI 54304
Brown County (773) 551-9490
QASEM FAISAL AQRABAWI DMD
Dentist (General Practice)
1551 PARK PL STE 300
GREEN BAY, WI 54304
Brown County (920) 365-5365
DR. MEHDI HEDROUG
Dentist
1551 PARK PL STE 300
GREEN BAY, WI 54304
Brown County (920) 365-5365
GAURAV SOOD
Dentist (General Practice)
1551 PARK PL STE 300
GREEN BAY, WI 54304
Brown County (920) 365-5365
GREEN BAY DENTAL PROFESSIONALS LLC
Dentist
1551 PARK PL STE 300
GREEN BAY, WI 54304
Brown County (920) 345-5150
IMRAN HAMAYUN MIAN
Dentist
1551 PARK PL STE 300
GREEN BAY, WI 54304
Brown County (920) 327-8893

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tariq Elmadawy's NPI number?

The NPI number for Tariq Elmadawy is 1164109336. It was assigned to this individual provider in the NPPES registry on June 29, 2023.

Where is Tariq Elmadawy located?

Tariq Elmadawy practices at 1551 Park Pl Ste 300, Green Bay, WI 54304. The listed phone number is (920) 332-6644.

What is Tariq Elmadawy's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Tariq Elmadawy accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company, Delta Dental of Michigan, Guardian, HRI Dental & Vision and Humana and 2 other insurers list Tariq Elmadawy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tariq Elmadawy was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.