LISA GABRIELLE SALLOUM (NPI# 1588809206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588809206 |
| Entity Type | Individual |
| Full Name | LISA GABRIELLE SALLOUM |
| Credential | D.D.S. |
| Practice Address |
9000 Golfside Dr Suite A Jacksonville FL 32256-7793 |
| Mailing Address |
9000 Golfside Dr Suite B Jacksonville FL 32256-7793 |
| Practice Telephone | 9047378410 |
| Practice Fax Number | 9043671739 |
| Mailing Telephone | 9043671722 |
| Mailing Fax Number | 9043671739 |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN12847 | FL | Dental Providers |
| Street Address |
9000 GOLFSIDE DR SUITE A |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-7793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053690222 | Melanie Woodward Deloach | Dentist | 9000 Golfside Dr, Suite B, Jacksonville, FL 32256 | 2011-08-05 |
| 1194956144 | Tatyana I. Stepanchuk | Dentist | 9000 Golfside Dr, Suite B, Jacksonville, FL 32256-7793 | 2009-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235634205 | Geraldine Mackoul Ferris | Dentist | 2280 Shepard St Apt 505, Jacksonville, FL 32211-3284 | 2018-03-29 |
| 1871895680 | Michael Jordan Fetner | Dentist | 7043 Southpoint Pkwy S Ste B, Jacksonville, FL 32216-8742 | 2010-11-30 |
| 1720121791 | Luther Hill Hutchens Jr. | Dentist | 200 Doctors Dr Ste N, Jacksonville, NC 28546-6308 | 2007-02-15 |
| 1629127956 | Roger Duane Robinson Jr. | Dentist | 3595 Cardinal Point Dr, Jacksonville, FL 32257-5500 | 2007-01-09 |
| 1780747873 | Alan Robert Romans | Dentist | 9832 Baymeadows Rd, 200, Jacksonville, FL 32256 | 2006-12-19 |
| 1649341231 | Michael Albert Chanatry | Dentist | 3595 Cardinal Point Drive, Jacksonville, FL 32257 | 2006-11-13 |
| 1891707428 | Mohamed A Maksoud | Dentist | 9191 R G Skinner Pkwy #404, Jacksonville, FL 32256 | 2006-08-12 |
| 1396765889 | Christian Sven Berdy I | Dentist | 1511 Stockton St, Jacksonville, FL 32204-4521 | 2006-07-20 |
| 1265412290 | Richard E Aguila | Dentist | 13167 Atlantic Blvd, Jacksonville, FL 32225-3125 | 2006-01-17 |
| 1891790432 | Gary David Perlman | Dentist | 3990 San Jose Park Dr, Jacksonville, FL 32217-4613 | 2005-06-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
Please comment or provide details below to improve the information on LISA GABRIELLE SALLOUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.