Provider Demographics
NPI:1447572177
Name:SALEEM, RUBINA (DDS)
Entity Type:Individual
Prefix:
First Name:RUBINA
Middle Name:
Last Name:SALEEM
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:PO BOX 11568
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-4268
Mailing Address - Country:US
Mailing Address - Phone:913-428-1674
Mailing Address - Fax:866-591-0604
Practice Address - Street 1:1494A S ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3832
Practice Address - Country:US
Practice Address - Phone:330-724-7036
Practice Address - Fax:866-591-0604
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014127041223G0001X
OH30-0235251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0055038Medicaid