Healthcare Provider Details

I. General information

NPI: 1225932783
Provider Name (Legal Business Name): MELISSA JASMINE SOSA RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA JASMINE SALGADO

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 LANCASTER DR NE
SALEM OR
97305-1223
US

IV. Provider business mailing address

1063 RURAL AVE SE
SALEM OR
97302-3053
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone: 503-689-2743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH8993
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: