Healthcare Provider Details

I. General information

NPI: 1033761580
Provider Name (Legal Business Name): SALINA SAFAEI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5122 KATELLA AVE STE 112
LOS ALAMITOS CA
90720-2837
US

IV. Provider business mailing address

5122 KATELLA AVE STE 112
LOS ALAMITOS CA
90720-2837
US

V. Phone/Fax

Practice location:
  • Phone: 562-493-2807
  • Fax:
Mailing address:
  • Phone: 562-493-2807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number104026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: