Provider Demographics
NPI:1538237912
Name:SALAZAR, ARMANDO (DMD, MMSC)
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:DMD, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12002 SW 128TH CT
Mailing Address - Street 2:STE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4639
Mailing Address - Country:US
Mailing Address - Phone:305-238-5537
Mailing Address - Fax:305-238-5062
Practice Address - Street 1:12002 SW 128TH CT
Practice Address - Street 2:STE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4639
Practice Address - Country:US
Practice Address - Phone:305-238-5537
Practice Address - Fax:305-238-5062
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216891223G0001X
FLDN 185561223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice