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NPI Code Detail

MEDICARE: SAHAWNEH DENTAL CORPORATION

MEDICARE: SAHAWNEH DENTAL CORPORATION
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
1122300000XDentist

General Provider Information

NPI Number : 1588381164
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAHAWNEH DENTAL CORPORATION
Provider Business Mailing Address
First Line : 100 SPECTRUM CENTER DR STE 100
Second Line :
City : IRVINE
State : CA
Zip : 92618-4963
Country : US
Telephone Number : 714-578-6358
Fax Number :
Provider Business Practice Location Address
First Line : 3383 LONG BEACH BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4408
Country : US
Telephone Number : 562-424-1600
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. SHOROUQ SAMEER SAHAWNEH
Credential : DDS
Telephone Number : 714-578-6358
Provider Enumeration Date : 10/24/2022
Last Update Date : 10/24/2022

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Directions to “SAHAWNEH DENTAL CORPORATION ” Practice Location

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