Provider Demographics
NPI:1679146880
Name:SEDATION DENTAL LLC
Entity type:Organization
Organization Name:SEDATION DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-715-0265
Mailing Address - Street 1:3437 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3688
Mailing Address - Country:US
Mailing Address - Phone:330-389-3846
Mailing Address - Fax:
Practice Address - Street 1:3437 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3688
Practice Address - Country:US
Practice Address - Phone:330-389-3846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEDATION DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-24
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental