Provider Demographics
NPI:1659478337
Name:SALAZAR, ERNEST STEVEN (DDS)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:STEVEN
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 FRIENDS AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1406
Mailing Address - Country:US
Mailing Address - Phone:323-712-1537
Mailing Address - Fax:
Practice Address - Street 1:3525 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-1540
Practice Address - Country:US
Practice Address - Phone:323-721-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26523122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist