Provider Demographics
NPI:1487217865
Name:SALAVATI, ROXANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:
Last Name:SALAVATI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 S ROXBURY DR PH A
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4114
Mailing Address - Country:US
Mailing Address - Phone:424-421-4292
Mailing Address - Fax:
Practice Address - Street 1:436 N ROXBURY DR PH SOUTH-A
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5019
Practice Address - Country:US
Practice Address - Phone:310-276-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-21
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1081471223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics