Provider Demographics
NPI:1669589842
Name:ADAMS, SALMAN (DMD)
Entity type:Individual
Prefix:DR
First Name:SALMAN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 AVENEL ST
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001
Mailing Address - Country:US
Mailing Address - Phone:732-636-7866
Mailing Address - Fax:732-636-7887
Practice Address - Street 1:415 AVENEL ST
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001
Practice Address - Country:US
Practice Address - Phone:732-636-7866
Practice Address - Fax:732-636-7887
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042690122300000X
NJ22D101802700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01179253Medicaid