Healthcare Provider Details

I. General information

NPI: 1841890092
Provider Name (Legal Business Name): REFKA A SALIB DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2776 JOHN F KENNEDY BLVD
JERSEY CITY NJ
07306-5508
US

IV. Provider business mailing address

2776 JOHN F KENNEDY BLVD
JERSEY CITY NJ
07306-5508
US

V. Phone/Fax

Practice location:
  • Phone: 201-736-0679
  • Fax:
Mailing address:
  • Phone: 201-736-0679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02801600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02801600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: