Mariam Soldin-Wasfi, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

100518 Issued in CA

Practice address

24261 Grass St
Lake Forest, CA 92630-5243

Phone

(949) 278-9449

NPI assigned

Jul 22, 2016

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Mariam Soldin-Wasfi DMD Professional Corp

  • Dental Clinic/Center
  • San Juan Capistrano, CA
  • NPI 1114735677
  NPD Authorized official

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1396198636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24261 GRASS ST",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305243",
            "telephone_number": "949-278-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24261 GRASS ST",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305243",
            "telephone_number": "949-278-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLDIN-WASFI",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Socal Adolescent Wellness, Inc.
• Socal Adolescent Wellness, Inc.
• Socal Counseling Services
• Socal Empowered, LLC
• Sofia Rodriguez DDS, Inc.
• Amani Soliman, D.D.S.
• Rachel Soltani
• Ryan Michael Somers, DPT
• Song W. Jung. DDS. Inc
• Raul Sosa Jr.

• Dentist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.