Active NPI
Sameh Said Sallam, BDS,DDS
- Dentist
- Moreno Valley, CA
National Provider Identifier
1689921025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61610
- Practice address
- 26468 Sand Palm CT
Moreno Valley, CA 92555-2368 - Phone
- (951) 807-6510
- NPI assigned
- Aug 3, 2012
- Last updated
- Aug 14, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61610 | CA | Primary |
| Public Health Dentistry | 1223D0001X | 61610 | CA | |
| Endodontics | 1223E0200X | 61610 | CA | |
| General Practice Dentistry | 1223G0001X | 61610 | CA | |
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 61610 | CA | |
| Pediatric Dentistry | 1223P0221X | 61610 | CA | |
| Periodontics | 1223P0300X | 61610 | CA | |
| Prosthodontics | 1223P0700X | 61610 | CA | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 61610 | CA | |
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | 61610 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 61610 | CA |
Addresses
Primary practice location
26468 Sand Palm CT
Moreno Valley, CA 92555-2368
Mailing address
26468 Sand Palm CT
Moreno Valley, CA 92555-2368
Phone (951) 807-6510
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61610 | CA | MD | Oral and Maxillofacial Radiology Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344902400000",
"number": "1689921025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26468 SAND PALM CT",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925552368",
"telephone_number": "951-807-6510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26468 SAND PALM CT",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925552368",
"telephone_number": "951-807-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALLAM",
"first_name": "SAMEH",
"middle_name": "SAID",
"name_prefix": "Dr.",
"credential": "BDS,DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-03",
"last_updated": "2012-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61610",
"primary": true
},
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223X0008X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": "CA",
"license": "61610",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "61610",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.