Provider Demographics
NPI:1326209958
Name:SALMAN, JAMES BASIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BASIL
Last Name:SALMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 BRECKENRIDGE LANE
Mailing Address - Street 2:STE 20
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:46220
Mailing Address - Country:US
Mailing Address - Phone:502-459-8012
Mailing Address - Fax:502-459-8021
Practice Address - Street 1:3101 BRECKENRIDGE LANE
Practice Address - Street 2:STE 20
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:46220
Practice Address - Country:US
Practice Address - Phone:502-459-8012
Practice Address - Fax:502-459-8021
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL018001630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100160320Medicaid