Individual provider Active NPI

Rami Salloum

  • General Practice Dentistry
  • Bethlehem, PA
National Provider Identifier
1063583672
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS035810 Issued in PA
Practice address
3894 Courtney St
Suite # 105
Bethlehem, PA 18017-8920
Phone
(610) 317-2400
Fax
(610) 317-8600
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 55046 CA
General Practice Dentistry 1223G0001X DS035810 PA Primary

Addresses

Primary practice location

3894 Courtney St
Suite # 105
Bethlehem, PA 18017-8920

Mailing address

3894 Courtney St
Suite # 105
Bethlehem, PA 18017-8920
Phone (610) 317-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
55046CAMDGeneral Practice Dentistry
DS035810PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1063583672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3894 COURTNEY ST",
            "address_2": "SUITE # 105",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178920",
            "telephone_number": "610-317-2400",
            "fax_number": "610-317-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3894 COURTNEY ST",
            "address_2": "SUITE # 105",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178920",
            "telephone_number": "610-317-2400",
            "fax_number": "610-317-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLOUM",
        "first_name": "RAMI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55046",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.