Provider Demographics
NPI:1104348366
Name:SAAD, ERENE (DMD)
Entity type:Individual
Prefix:
First Name:ERENE
Middle Name:
Last Name:SAAD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 FIRENZE ST
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8830
Mailing Address - Country:US
Mailing Address - Phone:949-584-9956
Mailing Address - Fax:949-495-6102
Practice Address - Street 1:32112 CAMINO CAPISTRANO
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3717
Practice Address - Country:US
Practice Address - Phone:949-487-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1015311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice