Healthcare Provider Details

I. General information

NPI: 1336681576
Provider Name (Legal Business Name): FADY SAMIR SAAD GIRGIS D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 ORINDA WAY STE 301
ORINDA CA
94563-2520
US

IV. Provider business mailing address

23 ORINDA WAY STE 301
ORINDA CA
94563-2520
US

V. Phone/Fax

Practice location:
  • Phone: 714-468-6591
  • Fax:
Mailing address:
  • Phone: 714-468-6591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number101024
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number101024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: