Provider Demographics
NPI:1720353626
Name:SAMINI, SAMIRA (DDS)
Entity Type:Individual
Prefix:
First Name:SAMIRA
Middle Name:
Last Name:SAMINI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22896 HUNTER CRK
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4744
Mailing Address - Country:US
Mailing Address - Phone:949-370-8959
Mailing Address - Fax:
Practice Address - Street 1:601 DOVER DR STE 5
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-5721
Practice Address - Country:US
Practice Address - Phone:949-548-0966
Practice Address - Fax:949-548-9796
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics