Healthcare Provider Details

I. General information

NPI: 1700880275
Provider Name (Legal Business Name): JOEL MARC SALON DDS,MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34501 AURORA RD STE 301
SOLON OH
44139-3831
US

IV. Provider business mailing address

34501 AURORA RD STE 301
SOLON OH
44139-3831
US

V. Phone/Fax

Practice location:
  • Phone: 440-248-9097
  • Fax: 440-248-9099
Mailing address:
  • Phone: 440-248-9097
  • Fax: 440-248-9099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30-01-5247
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number35-04-7600-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: