Shorouq Sameer Sahawneh, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55643 Issued in CA

Practice address

550 Paularino Ave
Apt# K106
Costa Mesa, CA 92626-3273

Phone

(714) 436-1001

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235346750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PAULARINO AVE",
            "address_2": "APT# K106",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263273",
            "telephone_number": "714-436-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PAULARINO AVE",
            "address_2": "APT# K106",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263273",
            "telephone_number": "714-436-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHAWNEH",
        "first_name": "SHOROUQ",
        "middle_name": "SAMEER",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Safe Harbor's Capella LLC
• Safe Harbors Capella Inc.
• Saghatchi Dental Corporation
• Farshad Saghatchi, D.D.S.
• Sahawneh Dental Corporation (Bright Now Dental - Costa Mesa)
• Lily Said
• Mannat Kaur Saini, MD
• Saint Youstina
• Emily Elizabeth Sainz
• Marwah Sakaamini

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.