Individual provider Active NPI

Sabrina Rita Shaouni, D.D.S

  • General Practice Dentistry
  • Pontiac, MI
National Provider Identifier
1487941506
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020336 Issued in MI
Practice address
1620 N Perry St
Suite 1
Pontiac, MI 48340-3310
Phone
(248) 373-2321
Fax
(248) 373-2498
NPI assigned
Jul 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020336 MI Primary

Addresses

Primary practice location

1620 N Perry St
Suite 1
Pontiac, MI 48340-3310

Mailing address

20040 Mack Ave
Grosse Pointe Woods, MI 48236-2360
Phone (313) 882-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170130000170 MI Order and Referring Only - DentistPractitioner - Dentist 8325320260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Faircourt Dental PC General Practice CurrentSince Apr 9, 2024 Accepting new patients
Sabrina R Salim Dentistry PLLC CurrentSince Apr 9, 2024 Accepting new patients

Locations

20040 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 882-2000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1487941506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20040 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362360",
            "telephone_number": "313-882-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 N PERRY ST",
            "address_2": "SUITE 1",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483403310",
            "telephone_number": "248-373-2321",
            "fax_number": "248-373-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAOUNI",
        "first_name": "SABRINA",
        "middle_name": "RITA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-10",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.