Provider Demographics
NPI:1174047633
Name:SALEI, NINA (DMD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:SALEI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:SUBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2020 5TH AVE S APT 343
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2146
Mailing Address - Country:US
Mailing Address - Phone:484-470-5126
Mailing Address - Fax:
Practice Address - Street 1:2020 5TH AVE S APT 343
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2146
Practice Address - Country:US
Practice Address - Phone:484-470-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL64561223G0001X, 122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program