1922110006 NPI number — DR. RICHARD DAVID SALZMANN DMD

Table of content: DR. RICHARD DAVID SALZMANN DMD (NPI 1922110006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922110006 NPI number — DR. RICHARD DAVID SALZMANN DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALZMANN
Provider First Name:
RICHARD
Provider Middle Name:
DAVID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALZMANN
Provider Other First Name:
RICHARD
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD PA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1922110006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9720 STIRLING ROAD
Provider Second Line Business Mailing Address:
#209
Provider Business Mailing Address City Name:
COOPER CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-435-1102
Provider Business Mailing Address Fax Number:
954-435-3807

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9720 STIRLING RD
Provider Second Line Business Practice Location Address:
#209
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33024-8013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-435-1102
Provider Business Practice Location Address Fax Number:
954-435-3807
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0300X , with the licence number:  DN11159 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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