Provider Demographics
NPI:1134986854
Name:SARINA SOUMEEH DMD INC
Entity type:Organization
Organization Name:SARINA SOUMEEH DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUMEEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-795-9495
Mailing Address - Street 1:1743 ROSCOMARE RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1743 ROSCOMARE RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-2212
Practice Address - Country:US
Practice Address - Phone:310-795-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty