Individual provider Active NPI

Mirhamid Salek, DDS

  • Dentist
  • West Covina, CA
National Provider Identifier
1275969156
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64405 Issued in CA
Practice address
628 N Azusa Ave
West Covina, CA 91791
Phone
(626) 966-8408
Fax
(626) 608-5670
NPI assigned
Sep 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64405 CA Primary
Dentist 122300000X DE 60319906 WA

Addresses

Primary practice location

628 N Azusa Ave
West Covina, CA 91791

Mailing address

1021 Calle Sonrisa
Glendale, CA 91208-3036
Phone (626) 644-8618

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
I20211102001877 CA Practitioner - Oral Surgery 3274854187 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64405CAMDDentist
DE 60319906WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mirhamid Salek, DDS, Professional Corporation CurrentSince Jul 29, 2021 Accepting new patients

Locations

628 N Azusa Ave
West Covina, CA 91791
Phone (626) 966-8408

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1275969156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 CALLE SONRISA",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912083036",
            "telephone_number": "626-644-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 N AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "91791",
            "telephone_number": "626-966-8408",
            "fax_number": "626-608-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEK",
        "first_name": "MIRHAMID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64405",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60319906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.