Individual provider Active NPI

Shereen Naguib, DDS

  • Dentist
  • Tustin, CA
National Provider Identifier
1477938801
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46058 Issued in CA
Practice address
12575 Newport Ave
Suite B
Tustin, CA 92780-2451
Phone
(714) 731-6100
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46058 CA Primary

Addresses

Primary practice location

12575 Newport Ave
Suite B
Tustin, CA 92780-2451

Mailing address

24981 Fairtime Cir
Laguna Niguel, CA 92677-6010
Phone (949) 448-0156

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

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1477938801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24981 FAIRTIME CIR",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926776010",
            "telephone_number": "949-448-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12575 NEWPORT AVE",
            "address_2": "SUITE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802451",
            "telephone_number": "714-731-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGUIB",
        "first_name": "SHEREEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.