Provider Demographics
NPI:1275054066
Name:SOUMEEH, SARA E (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:E
Last Name:SOUMEEH
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 1:27421 TOURNEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5646
Mailing Address - Country:US
Mailing Address - Phone:310-754-6143
Mailing Address - Fax:
Practice Address - Street 1:27421 TOURNEY RD STE 100
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5646
Practice Address - Country:US
Practice Address - Phone:310-754-6143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN221691223E0200X
CADDS1009201223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics