Provider Demographics
NPI:1124219886
Name:SALAO, ERIKA B (DMD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:B
Last Name:SALAO
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 1:3756 W AVENUE 40 STE 1C
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3667
Mailing Address - Country:US
Mailing Address - Phone:323-255-1700
Mailing Address - Fax:323-255-1829
Practice Address - Street 1:3756 W AVENUE 40 STE 1C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-3667
Practice Address - Country:US
Practice Address - Phone:323-255-1700
Practice Address - Fax:323-255-1829
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA499871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice