Provider Demographics
NPI:1720745466
Name:SALEHPOOR, DANIAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIAL
Middle Name:
Last Name:SALEHPOOR
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 1:63 W SQUIRE DR APT 7
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1753
Mailing Address - Country:US
Mailing Address - Phone:512-436-2911
Mailing Address - Fax:
Practice Address - Street 1:3045 SMITH RD STE 100
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4449
Practice Address - Country:US
Practice Address - Phone:330-668-1165
Practice Address - Fax:330-668-1169
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist