MEDICARE: AHMAD SALAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	063139	NY
2	122300000X	Dentist	0401418683	VA

General Provider Information

NPI Number	:	1447936760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD SALAH

Provider Business Mailing Address
First Line	:	3326 SOUTHWESTERN BLVD
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-1524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 CEDAR CREEK GRADE STE 211
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6454
Country	:	US
Telephone Number	:	540-486-5111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	12/01/2023

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Directions to “ AHMAD SALAH ” Practice Location

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