Provider Demographics
NPI:1740909506
Name:SMILEGIVERS
Entity type:Organization
Organization Name:SMILEGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMOHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-430-9207
Mailing Address - Street 1:5805 WHITE OAK AVE # 16714
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1150
Mailing Address - Country:US
Mailing Address - Phone:818-430-9207
Mailing Address - Fax:
Practice Address - Street 1:2730 GANAHL ST RM 25A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2019
Practice Address - Country:US
Practice Address - Phone:323-269-0415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty