NPIMap

Organization Active NPI

Sahawneh Dental Corporation

  • Dentist
  • La Quinta, CA
National Provider Identifier
1104200245
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55643 Issued in CA
Legal business name
SAHAWNEH DENTAL CORPORATION
Practice address
79255 Highway 111
Suite 1a & 1B
La Quinta, CA 92253-8301
Phone
(760) 771-1200
Fax
(760) 564-6370
NPI assigned
Jul 18, 2015
Organization subpart
Yes
Parent organization
SAHAWNEH DENTAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Shorouq Sahawneh, DDS
Title
Owner Dentist
Phone
(714) 578-6358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 55643 CA Primary

Addresses

Primary practice location

79255 Highway 111
Suite 1a & 1B
La Quinta, CA 92253-8301

Mailing address

100 Spectrum Center Dr
Ste 100
Irvine, CA 92618-4962
Phone (714) 578-6358

Other names 1

  • Bright Now Dental - La Quinta Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fratt Dental Corporation132 organizations share this tax ID, including this one
Part of
Fratt Dental Corporation

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1104200245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPECTRUM CENTER DR",
            "address_2": "STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184962",
            "telephone_number": "714-578-6358",
            "fax_number": "949-861-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79255 HIGHWAY 111",
            "address_2": "SUITE 1A & 1B",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922538301",
            "telephone_number": "760-771-1200",
            "fax_number": "760-564-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAHAWNEH DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAHAWNEH DENTAL CORPORATION",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "SAHAWNEH",
        "authorized_official_first_name": "SHOROUQ",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "714-578-6358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Now Dental - La Quinta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.