Provider Demographics
NPI:1740720648
Name:SALEHPOUR, ALI (DDS, MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:SALEHPOUR
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 CASS ST STE B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4547
Mailing Address - Country:US
Mailing Address - Phone:831-884-5141
Mailing Address - Fax:831-884-5176
Practice Address - Street 1:950 CASS ST STE B
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4547
Practice Address - Country:US
Practice Address - Phone:831-884-5141
Practice Address - Fax:831-884-5176
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1013891223S0112X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery