Sandra Azer Shenouda, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

106515 Issued in CA

Practice address

1199 N E St
San Bernardino, CA 92410-3507

Phone

(909) 269-8472

NPI assigned

Jul 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1902477979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 E OLYMPIC DR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917627278",
            "telephone_number": "909-525-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 N E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103507",
            "telephone_number": "909-269-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOUDA",
        "first_name": "SANDRA",
        "middle_name": "AZER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "106515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Michelle Sheehy, APCC#16702
• Nicola Joy Sheftick
• Brittany Leigh Shelton
• Jenee E Shelton
• Demiana A Shenouda
• Wilma Leardean Shepard, LCSW
• Nathan Shepherd
• Kenneth Lemelle Sherrill Jr.
• Myung Shik Shin, DDS
• Sook-Ja Shin, M.D.

• Public Health Dentistry in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Public Health Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.