Individual provider Active NPI

Saliem Melles Tsighe, D.M.D

  • Dentist
  • Modesto, CA
National Provider Identifier
1013279074
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62380 Issued in CA
Practice address
2200 McHenry Ave Ste B
Modesto, CA 95350-3255
Phone
(209) 526-9132
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62380 CA Primary

Addresses

Primary practice location

2200 McHenry Ave Ste B
Modesto, CA 95350-3255

Mailing address

2200 McHenry Ave Ste B
Modesto, CA 95350-3255
Phone (209) 526-9132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251219003155 CA Practitioner - Dentist 1153636022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Univ of Nevada, Las Vegas School of Dental Med, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5220 Pacific Concourse Dr
Suite 120
Los Angeles, CA 90045-6244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62380CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fulbright Dental Group, PC CurrentSince Nov 1, 2025 Accepting new patients

Locations

5220 Pacific Concourse Dr
Ste 120
Los Angeles, CA 90045
Phone (310) 228-0396

1801 W Olympic Blvd
#1738
Pasadena, CA 91199

188 Frank West Cir
Ste G
Stockton, CA 95206
Phone (310) 337-1694

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1013279074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MCHENRY AVE STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503255",
            "telephone_number": "209-526-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MCHENRY AVE STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503255",
            "telephone_number": "209-526-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIGHE",
        "first_name": "SALIEM",
        "middle_name": "MELLES",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.