Provider Demographics
NPI:1093731465
Name:SALIN, DONNA SUSAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:SUSAN
Last Name:SALIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N BROAD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1052
Mailing Address - Country:US
Mailing Address - Phone:215-855-1173
Mailing Address - Fax:215-855-1936
Practice Address - Street 1:2100 N BROAD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1052
Practice Address - Country:US
Practice Address - Phone:215-855-1173
Practice Address - Fax:215-855-1936
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0350041223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DS035004OtherSTATE LICENSE
113237OtherCIGNA
115889OtherAMERICAN ASSOCIATION OF E
054393OtherAMERIHEALTH
054393OtherBLUE SHIELD
1560OtherAETNA DMO
89839OtherAETNA
89839OtherAETNA