Active NPI
Sarah Sourialle, DMD
- Dentist
- San Bernardino, CA
National Provider Identifier
1053090217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110092
- Practice address
- 399 E Highland Ave Ste 120
San Bernardino, CA 92404-3812 - Phone
- (909) 881-0645
- NPI assigned
- Jul 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 110092 | CA | Primary |
Addresses
Primary practice location
399 E Highland Ave Ste 120
San Bernardino, CA 92404-3812
Mailing address
9 Saint Raphael
Laguna Niguel, CA 92677-2761
Phone (909) 732-7487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110092 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southland Dental Group Antoine Sourialle DDS Inc | Past | Accepting new patients | |
| Bridgeport Smiles | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- San Bernardino, CA
- NPI 1588715031
-
- General Practice Dentistry
- Chicago, IL
- NPI 1528487220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1053090217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 SAINT RAPHAEL",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926772761",
"telephone_number": "909-732-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 E HIGHLAND AVE STE 120",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043812",
"telephone_number": "909-881-0645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOURIALLE",
"first_name": "SARAH",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
- Ryan Soto, CRNA
- Vanessa Soto
- Victoria Christina Soto
- Sound Mind Counseling and Consulting, a Professional Licensed Clinical Social Worker Corporation
- Antoine O. Sourialle, D.D.S.
- Larry E Southard, MA MFT
- Southern California Emergency Medicine
- Southland Anesthesia Consultants Inc
- Southland Cardiology Medical Group
- Southland Dental Group Antoine Sourialle DDS Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.