Provider Demographics
NPI:1497984835
Name:SALINAS, JONATHAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:B
Last Name:SALINAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 SAINT ROSE PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3504
Mailing Address - Country:US
Mailing Address - Phone:702-792-6700
Mailing Address - Fax:
Practice Address - Street 1:3195 SAINT ROSE PKWY STE 210
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3504
Practice Address - Country:US
Practice Address - Phone:702-792-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112136207Y00000X
390200000X
NV15367207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1497984835Medicaid
CA1497984835Medicaid