Individual provider Active NPI

Omar Salameh

  • Dentist
  • Streetsboro, OH
National Provider Identifier
1164665675
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30023312 Issued in OH
Practice address
9519 State Route 14
Streetsboro, OH 44241-5227
Phone
(615) 715-0265
NPI assigned
Apr 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30023312 OH Primary

Addresses

Primary practice location

9519 State Route 14
Streetsboro, OH 44241-5227

Mailing address

9519 State Route 14
Streetsboro, OH 44241-5227
Phone (615) 715-0265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160510001386 OH Order and Referring Only - DentistPractitioner - Dentist 8729377064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30023312OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sedation Dental LLC CurrentSince Aug 1, 2021 Accepting new patients
Dr.Salameh and Partners LLC Past Accepting new patients

Locations

3437 Center Rd
Brunswick, OH 44212
Phone (201) 969-6924

Organizations & group practices 2

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1164665675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9519 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415227",
            "telephone_number": "615-715-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9519 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415227",
            "telephone_number": "615-715-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMEH",
        "first_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30023312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

Verify at the official NPI Registry.