Individual provider Active NPI

David Samir Sawiris, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1427567056
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS102030 Issued in CA
Practice address
2515 W Pico Blvd
Los Angeles, CA 90006-4003
Phone
(213) 384-4555
NPI assigned
Sep 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS102030 CA
Dentist 122300000X DDS102030 CA Primary

Addresses

Primary practice location

2515 W Pico Blvd
Los Angeles, CA 90006-4003

Mailing address

4517 Gable Dr
Encino, CA 91316-4355
Phone (818) 378-7265

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180108003176 CA Order and Referring Only - DentistPractitioner - Dentist 7618236126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102030CAMDClinical Social Worker
DDS102030CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1427567056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 GABLE DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164355",
            "telephone_number": "818-378-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064003",
            "telephone_number": "213-384-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWIRIS",
        "first_name": "DAVID",
        "middle_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102030",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.