Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Tariq Elmadawy

Individual provider Dentist · NPI 1164109336

Dr. Tariq Elmadawy is a Dentist in Green Bay, Wisconsin. Practices as a sole proprietor. Licensed in Michigan and Wisconsin.

Licensed in
MI, WI
In the registry since
2023
Specialties on file
2

Practice location Address checks out

1551 Park Pl Ste 300
Green Bay, WI 54304-1969
Phone: (920) 332-6644
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 2901601681 (MI)
Dentist Taxonomy 122300000X · Licence 6001237-15 (WI)

Record details

NPI number1164109336
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 29, 2023
Last updated in NPPESJanuary 27, 2025
Certification dateJanuary 27, 2025

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