Provider Demographics
NPI:1750149258
Name:NATASHA VEGA-SALAS DDS INC
Entity type:Organization
Organization Name:NATASHA VEGA-SALAS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:ROSEMA
Authorized Official - Last Name:VEGA-SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-279-0107
Mailing Address - Street 1:5954 NEWCOMB ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3536
Mailing Address - Country:US
Mailing Address - Phone:954-279-0107
Mailing Address - Fax:
Practice Address - Street 1:910 HALE PL STE 204
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4509
Practice Address - Country:US
Practice Address - Phone:954-279-0107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty