Basic Information
| Provider Information | |||||||||
| NPI: | 1699818450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALAMA | ||||||||
| FirstName: | FOUAD | ||||||||
| MiddleName: | SAAD EL-DIN HAKY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 808 S 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216291398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104792650 | ||||||||
| FaxNumber: | 8339161012 | ||||||||
| Practice Location | |||||||||
| Address1: | 808 S 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216291398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104792650 | ||||||||
| FaxNumber: | 8339161012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 11/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0221X | 104 | NE | Y | Dental Providers | Dentist | Pediatric Dentistry |
ID Information
| ID | Type | State | Issuer | Description | 0576249 | 05 | IA | MEDICAID | 47078998513 | 05 | NE | MEDICAID | 4678 | 01 | NE | BC/BS | OTHER |