MEDICARE: RANIM SHAWAREB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7856	OK

General Provider Information

NPI Number	:	1639918139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANIM SHAWAREB

Provider Business Mailing Address
First Line	:	4912 HUNTER BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73179-7023
Country	:	US
Telephone Number	:	918-850-0696
Fax Number	:

Provider Business Practice Location Address
First Line	:	7215 E RENO AVE
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-4446
Country	:	US
Telephone Number	:	405-737-5905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2024
Last Update Date	:	05/23/2024

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Directions to “ RANIM SHAWAREB ” Practice Location

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