Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN25148 | FL |
N | 1223D0001X | Dental Public Health | DRP1825 | FL |
N | 124Q00000X | Dental Hygienist | DH19582 | FL |
NPI | 1255857801 |
---|---|
Provider Name | Dr. Javier Salmen Namen Alarcon |
First Address | Miami Springs, FL 33166-5026 |
Second Address | Miami Springs, FL 33166-5026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2017 |
Last Update Date | 20/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0022113000 | (05) | FL |