Provider Demographics
NPI:1467525022
Name:RAMADAN, SALAM T (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALAM
Middle Name:T
Last Name:RAMADAN
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 1:3315 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3787
Mailing Address - Country:US
Mailing Address - Phone:405-607-4845
Mailing Address - Fax:405-607-6346
Practice Address - Street 1:3315 NW 63RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3787
Practice Address - Country:US
Practice Address - Phone:405-607-4845
Practice Address - Fax:405-607-6346
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5361122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist