Provider Demographics
NPI:1669828018
Name:MASSEI, SALINA ROSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALINA
Middle Name:ROSE
Last Name:MASSEI
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 1:1912 BROADWAY
Mailing Address - Street 2:#301
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2860
Mailing Address - Country:US
Mailing Address - Phone:909-374-6964
Mailing Address - Fax:
Practice Address - Street 1:15634 WHITTWOOD LN
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2324
Practice Address - Country:US
Practice Address - Phone:562-501-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty