Healthcare Provider Details

I. General information

NPI: 1255857801
Provider Name (Legal Business Name): JAVIER SALMEN NAMEN ALARCON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20612 NW 27TH AVE
MIAMI GARDENS FL
33056-1469
US

IV. Provider business mailing address

5607 NW 27TH AVE STE 1
MIAMI FL
33142-2826
US

V. Phone/Fax

Practice location:
  • Phone: 786-262-5174
  • Fax:
Mailing address:
  • Phone: 305-805-1700
  • Fax: 305-805-1715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN25148
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: