Provider Demographics
NPI:1427567056
Name:SAWIRIS, DAVID SAMIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SAMIR
Last Name:SAWIRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 GABLE DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4355
Mailing Address - Country:US
Mailing Address - Phone:818-378-7265
Mailing Address - Fax:
Practice Address - Street 1:2515 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4003
Practice Address - Country:US
Practice Address - Phone:213-384-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1020301223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice