Provider Demographics
NPI:1891190963
Name:SAHAWNEH DENTAL CORPORATION
Entity Type:Organization
Organization Name:SAHAWNEH DENTAL CORPORATION
Other - Org Name:BRIGHT NOW DENTAL - GRANADA HILLS
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:SAHAWNEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-578-6358
Mailing Address - Street 1:18121 CHATSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5610
Mailing Address - Country:US
Mailing Address - Phone:818-491-0056
Mailing Address - Fax:818-363-2867
Practice Address - Street 1:18121 CHATSWORTH ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5610
Practice Address - Country:US
Practice Address - Phone:818-491-0056
Practice Address - Fax:818-363-2867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X
CA55643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty