Healthcare Provider Details

I. General information

NPI: 1588344287
Provider Name (Legal Business Name): DR. ALA-EL-DEAN SAMI SALEM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. DEAN SALEM

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 W RIDGEWOOD DR
PARMA OH
44129-5524
US

IV. Provider business mailing address

31216 E CHURCHILL LN
WESTLAKE OH
44145-3791
US

V. Phone/Fax

Practice location:
  • Phone: 216-642-6291
  • Fax:
Mailing address:
  • Phone: 440-319-9024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.027332
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: