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General NPI Number Information
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NPI Number | 1568635480
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Entity Type | Individual
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Provider Name | SANAA SHAMAIL TARIQ D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 9 MACARTHUR PL UNIT 509
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City | SANTA ANA
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State | CA
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Zip | 92707-6741
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Country | US
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Telephone | 954-881-0357
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Fax |
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Provider Business Mailing Address
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Address Line | 9 MACARTHUR PL UNIT 509
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City | SANTA ANA
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State | CA
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Zip | 92707-6741
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Country | US
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Telephone | 954-881-0357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 17977
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 24452
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61038
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License Number State | CA
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