Provider Demographics
NPI:1861473399
Name:SALOSHIN, CLIFFORD N (DDS)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:N
Last Name:SALOSHIN
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:PO BOX 1257
Mailing Address - Street 2:PARKCHESTER STATION
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-0581
Mailing Address - Country:US
Mailing Address - Phone:718-829-4646
Mailing Address - Fax:
Practice Address - Street 1:2277 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5012
Practice Address - Country:US
Practice Address - Phone:718-829-4646
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034833122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00623285Medicaid