Individual provider Active NPI

Sean Pairawan, DDS

  • Dentist
  • City of Industry, CA
National Provider Identifier
1821673468
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS108742 Issued in CA
Practice address
21750 Valley Blvd Ste C
City of Industry, CA 91789-0939
Phone
(909) 595-0807
NPI assigned
Mar 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61298996 WA
Dentist 122300000X DDS108742 CA Primary

Addresses

Primary practice location

21750 Valley Blvd Ste C
City of Industry, CA 91789-0939

Mailing address

21750 Valley Blvd Ste C
City of Industry, CA 91789-0939
Phone (909) 595-0807

Other practice location 1

1200 12th Ave S Ste 901
Seattle, WA 98144
Phone (206) 548-7553

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS108742CAMDDentist
DE61298996WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Winston & Letwin DDS, PLLC PastSince Jul 24, 2022 Accepting new patients
Peregrine Pacific Anesthesia PLLC PastSince Mar 1, 2021 Accepting new patients
Pandhoh Dental Corporation PastSince Oct 22, 2023 Accepting new patients

Organizations & group practices 3

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1821673468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21750 VALLEY BLVD STE C",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917890939",
            "telephone_number": "909-595-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21750 VALLEY BLVD STE C",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917890939",
            "telephone_number": "909-595-0807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 12th Ave S Ste 901",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98144",
            "country_code": "US",
            "telephone_number": "206-548-7553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAIRAWAN",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61298996",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS108742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.