NPIMap

Organization Active NPI

Sahawneh Dental Corporation

  • Dentist
  • San Pedro, CA
National Provider Identifier
1649944703
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SAHAWNEH DENTAL CORPORATION
Practice address
640 S Gaffey St
San Pedro, CA 90731-3027
Phone
(310) 548-1273
NPI assigned
Aug 3, 2021
Organization subpart
Yes
Parent organization
SAHAWNEH DENTAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Shorouq Sameer Sahawneh
Title
Owner
Phone
(714) 578-6358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

640 S Gaffey St
San Pedro, CA 90731-3027

Mailing address

100 Spectrum Center Dr Ste 1500
Irvine, CA 92618-4984
Phone (949) 308-9792

Other names 1

  • Bright Now Dental San Pedro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fratt Dental Corporation132 organizations share this tax ID, including this one
Part of
Fratt Dental Corporation

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

640 S Gaffey St
San Pedro, CA 90731
Phone (310) 548-1273

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1649944703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPECTRUM CENTER DR STE 1500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184984",
            "telephone_number": "949-308-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313027",
            "telephone_number": "310-548-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAHAWNEH DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAHAWNEH DENTAL CORPORATION",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "SAHAWNEH",
        "authorized_official_first_name": "SHOROUQ",
        "authorized_official_middle_name": "SAMEER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-578-6358"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Now Dental San Pedro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.