Provider Demographics
NPI:1427883792
Name:SHAMOUN DENTAL PLLC
Entity type:Organization
Organization Name:SHAMOUN DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GOERINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-682-4971
Mailing Address - Street 1:4005 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2134
Mailing Address - Country:US
Mailing Address - Phone:248-682-4971
Mailing Address - Fax:248-682-4515
Practice Address - Street 1:4005 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2134
Practice Address - Country:US
Practice Address - Phone:248-682-4971
Practice Address - Fax:248-682-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental