Provider Demographics
NPI:1467349746
Name:SEDEHI, SAMIRA SADOUGHI (DMD)
Entity type:Individual
Prefix:
First Name:SAMIRA
Middle Name:SADOUGHI
Last Name:SEDEHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19512 SIERRA SANTO RD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-3834
Mailing Address - Country:US
Mailing Address - Phone:479-409-4542
Mailing Address - Fax:
Practice Address - Street 1:32391 CAMINO CAPISTRANO # B
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-4519
Practice Address - Country:US
Practice Address - Phone:949-805-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1115781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice