Provider Demographics
NPI:1336459734
Name:MOOSA, SALIMA IRFAN (DDS)
Entity type:Individual
Prefix:DR
First Name:SALIMA
Middle Name:IRFAN
Last Name:MOOSA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SALIMA
Other - Middle Name:
Other - Last Name:KARIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2629 DAMSEL CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5783
Mailing Address - Country:US
Mailing Address - Phone:972-809-0961
Mailing Address - Fax:
Practice Address - Street 1:2629 DAMSEL CHERRY LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-5783
Practice Address - Country:US
Practice Address - Phone:972-809-0961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice