Individual provider Active NPI

Yara Salem

  • Dentist
  • Tempe, AZ
National Provider Identifier
1750790879
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63700 Issued in CA
Practice address
2139 E Southern Ave
Tempe, AZ 85282-7503
Phone
(713) 474-3279
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63700 CA Primary

Addresses

Primary practice location

2139 E Southern Ave
Tempe, AZ 85282-7503

Mailing address

148 W Myrna LN
Tempe, AZ 85284-3045
Phone (713) 474-3279

Other practice location 1

81735 US Highway 111 Ste A
Indio, CA 92201-0715
Phone (888) 856-0124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150904000700 AZ Order and Referring Only - DentistPractitioner - Dentist 9830405844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63700CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Dental PLLC Dentist CurrentSince Oct 25, 2020 Accepting new patients

Locations

2139 E Southern Ave
Tempe, AZ 85282
Phone (480) 360-3311

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": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1750790879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 W MYRNA LN",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843045",
            "telephone_number": "713-474-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827503",
            "telephone_number": "713-474-3279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81735 US Highway 111 Ste A",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922010715",
            "country_code": "US",
            "telephone_number": "888-856-0124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALEM",
        "first_name": "YARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2020-10-18",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.