Provider Demographics
NPI:1376259085
Name:SALEH, IBRAHIM M (DDS)
Entity type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:M
Last Name:SALEH
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 1:11408 AUTUMN LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-2505
Mailing Address - Country:US
Mailing Address - Phone:210-907-4874
Mailing Address - Fax:
Practice Address - Street 1:11408 AUTUMN LEAF WAY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-2505
Practice Address - Country:US
Practice Address - Phone:210-907-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist