Provider Demographics
NPI:1518225705
Name:SHOROUQ SAHAWNEH
Entity Type:Organization
Organization Name:SHOROUQ SAHAWNEH
Other - Org Name:BRIGHTNOW DENTAL OXNARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOROUQ
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOROUQ SAHAWNEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-578-6358
Mailing Address - Street 1:355 W ESPLANADE DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1234
Mailing Address - Country:US
Mailing Address - Phone:805-288-3080
Mailing Address - Fax:805-485-6237
Practice Address - Street 1:355 W ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1234
Practice Address - Country:US
Practice Address - Phone:805-288-3080
Practice Address - Fax:805-485-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55643122300000X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty