Provider Demographics
NPI:1912098898
Name:SAWA, SHLAIMON TOMA (DDS)
Entity Type:Individual
Prefix:
First Name:SHLAIMON
Middle Name:TOMA
Last Name:SAWA
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 1:407 W MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3226
Mailing Address - Country:US
Mailing Address - Phone:619-401-0444
Mailing Address - Fax:619-401-0485
Practice Address - Street 1:407 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3226
Practice Address - Country:US
Practice Address - Phone:619-401-0444
Practice Address - Fax:619-401-0485
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist