Provider Demographics
NPI:1114570579
Name:OWEIS, SARAH SAMIR (DMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SAMIR
Last Name:OWEIS
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 1:200 W SAHARA AVE UNIT 506
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-5098
Mailing Address - Country:US
Mailing Address - Phone:925-719-2682
Mailing Address - Fax:
Practice Address - Street 1:4301 E SUNSET RD STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2238
Practice Address - Country:US
Practice Address - Phone:702-465-8187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV72501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice