Clifford T Salk, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12006043 Issued in IN

Practice address

122 W Washington Blvd
Fort Wayne, IN 46802

Phone

(260) 423-2521

Fax

(260) 423-6314

NPI assigned

Dec 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548323801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W WASHINGTON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46802",
            "telephone_number": "260-423-2521",
            "fax_number": "260-423-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W WASHINGTON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46802",
            "telephone_number": "260-423-2521",
            "fax_number": "260-423-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALK",
        "first_name": "CLIFFORD",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12006043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdelaziz A Saleh, MD
• Ronda J. Salge, LCSW
• Marcos Salinas, MS. ED.
• Erin S Salisbury, FNP
• Michelle L Salisbury, CNP
• Salkeld Family Dental, LLC
• Steven Charles Salkeld, D.D.S.
• Catherine Sallaz, MHC
• Marisa Nicole Salmeri, M.S. - OCCUPATIONAL
• Kelli Salmon, PHARMD

• Dentist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.