Provider Demographics
NPI:1487941506
Name:SHAOUNI, SABRINA RITA (DDS)
Entity type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:RITA
Last Name:SHAOUNI
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 1:20040 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2360
Mailing Address - Country:US
Mailing Address - Phone:313-882-2000
Mailing Address - Fax:
Practice Address - Street 1:1620 N PERRY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-3310
Practice Address - Country:US
Practice Address - Phone:248-373-2321
Practice Address - Fax:248-373-2498
Is Sole Proprietor?:No
Enumeration Date:2011-07-10
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010203361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice