Provider Demographics
NPI:1669674974
Name:SALAMATI, AFSHIN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:AFSHIN
Middle Name:
Last Name:SALAMATI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 N ROXBURY DR
Mailing Address - Street 2:SUITE 912
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4206
Mailing Address - Country:US
Mailing Address - Phone:310-275-1090
Mailing Address - Fax:310-275-1093
Practice Address - Street 1:465 N ROXBURY DR
Practice Address - Street 2:SUITE 912
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4206
Practice Address - Country:US
Practice Address - Phone:310-275-1090
Practice Address - Fax:310-275-1093
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44077122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist