Provider Demographics
NPI:1235542457
Name:ELENA SINIAVER, DMD PC
Entity Type:Organization
Organization Name:ELENA SINIAVER, DMD PC
Other - Org Name:ALERIS SALEM DENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINIAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-745-0055
Mailing Address - Street 1:90 LAFAYETTE ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4077
Mailing Address - Country:US
Mailing Address - Phone:978-745-0055
Mailing Address - Fax:978-745-0058
Practice Address - Street 1:90 LAFAYETTE ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4077
Practice Address - Country:US
Practice Address - Phone:978-745-0055
Practice Address - Fax:978-745-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN201181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty