Provider Demographics
NPI:1952195604
Name:AWAMLEH, SALAM (DMD)
Entity type:Individual
Prefix:
First Name:SALAM
Middle Name:
Last Name:AWAMLEH
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 1:4520 JAMESTOWN DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3371
Mailing Address - Country:US
Mailing Address - Phone:252-399-9053
Mailing Address - Fax:
Practice Address - Street 1:2071 RANCHO VALLEY DR STE 140
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-7105
Practice Address - Country:US
Practice Address - Phone:909-374-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1112251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice