Provider Demographics
NPI:1356664585
Name:SALHA, LENA J (DDS)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:J
Last Name:SALHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 STECK AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8620
Mailing Address - Country:US
Mailing Address - Phone:512-345-0400
Mailing Address - Fax:512-345-0402
Practice Address - Street 1:4041 STECK AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8620
Practice Address - Country:US
Practice Address - Phone:512-345-0400
Practice Address - Fax:512-345-0402
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2046674-01Medicaid
TX2046591-01Medicaid