Provider Demographics
NPI:1194762583
Name:ADJAJ, SALWAN WESAM (DMD)
Entity type:Individual
Prefix:DR
First Name:SALWAN
Middle Name:WESAM
Last Name:ADJAJ
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 1:5155 VINE ST
Mailing Address - Street 2:#616
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3381
Mailing Address - Country:US
Mailing Address - Phone:503-969-8471
Mailing Address - Fax:
Practice Address - Street 1:20015 SW PACIFIC HWY
Practice Address - Street 2:#220
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9316
Practice Address - Country:US
Practice Address - Phone:503-625-3838
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD87311223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics