Provider Demographics
NPI:1346450509
Name:SALAVERIA, JOEY MATHISON (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:MATHISON
Last Name:SALAVERIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1562 OHARA CT
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:CA
Mailing Address - Zip Code:94517-1068
Mailing Address - Country:US
Mailing Address - Phone:925-407-5651
Mailing Address - Fax:925-672-4496
Practice Address - Street 1:5442 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 70
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3800
Practice Address - Country:US
Practice Address - Phone:925-524-0444
Practice Address - Fax:925-524-0404
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA514251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice