Provider Demographics
NPI:1477724920
Name:SALAMEH, TAREQ MOHAMMAD (DDS)
Entity type:Individual
Prefix:DR
First Name:TAREQ
Middle Name:MOHAMMAD
Last Name:SALAMEH
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 1:10620 CRESTWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-4403
Mailing Address - Country:US
Mailing Address - Phone:561-827-1164
Mailing Address - Fax:703-361-0127
Practice Address - Street 1:10620 CRESTWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4403
Practice Address - Country:US
Practice Address - Phone:561-827-1164
Practice Address - Fax:703-361-0127
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2023-05-11
Deactivation Date:2013-02-27
Deactivation Code:
Reactivation Date:2013-05-07
Provider Licenses
StateLicense IDTaxonomies
VA0401411988122300000X
DCDEN1000876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist