Provider Demographics
NPI:1215394739
Name:ALSALEH, MAJD (BDS)
Entity Type:Individual
Prefix:DR
First Name:MAJD
Middle Name:
Last Name:ALSALEH
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 E LAFAYETTE PL
Mailing Address - Street 2:UNIT#1201
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1395
Mailing Address - Country:US
Mailing Address - Phone:414-877-3827
Mailing Address - Fax:
Practice Address - Street 1:1235 N RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4314
Practice Address - Country:US
Practice Address - Phone:847-259-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL0190312661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program