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SMILE SAN CLEMENTE
NPI 1962043919
Dentist - General Practice in San Clemente, CA

Active since October 01, 2019
653 CAMINO DE LOS MARES STE 113, SAN CLEMENTE, CA 92673(949) 248-7772 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 10, 2021, Oct 1, 2019 (2 updates tracked since 2019).

About Smile San Clemente NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SMILE SAN CLEMENTE (NPI 1962043919) is a healthcare organization registered as a general practice in San Clemente, California and active in the NPI registry since October 2019. The organization lists Shahin Mahallati, Owner, as its authorized official.

NPPES Registry Identity

NPI1962043919
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSHAHIN MAHALLATI DENTAL CORP
Location Address653 CAMINO DE LOS MARES STE 113San Clemente, CA 92673-2856
Mailing Address653 Camino De Los Mares Ste 113San Clemente, CA 92673-2856 · (949) 248-7772 · Fax (949) 248-0516
Phone(949) 248-7772
Organization SubpartNo
Authorized OfficialShahin MahallatiOwner · (949) 248-7772
Enumeration DateOctober 1, 2019
Last NPPES UpdateNovember 10, 20212 updates tracked since enumeration
NPPES CertifiedNovember 10, 2021
✔ NPI 1962043919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
653 CAMINO DE LOS MARES STE 113, San Clemente, CA 92673
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Other Names 1

Doing Business AsSmile San Clemente

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAHIN MAHALLATI D.D.S.
Dentist (General Practice)
653 CAMINO DE LOS MARES STE 113
SAN CLEMENTE, CA 92673
Orange County (949) 248-7772
DR. SACHIKO VIRGINIA FUKUMAN DDS
Dentist (General Practice)
653 CAMINO DE LOS MARES STE 113
SAN CLEMENTE, CA 92673
Orange County (949) 248-7772

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shahin Mahallati Dental Corp's NPI number?

The NPI number for Shahin Mahallati Dental Corp is 1962043919. It was assigned to this organization in the NPPES registry on October 1, 2019. The provider is doing business as Smile San Clemente.

Where is Shahin Mahallati Dental Corp located?

Shahin Mahallati Dental Corp is located at 653 Camino De Los Mares Ste 113, San Clemente, CA 92673. The listed phone number is (949) 248-7772.

What is Shahin Mahallati Dental Corp's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Shahin Mahallati Dental Corp was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.