Provider Demographics
NPI:1376435073
Name:ROOTS DENTAL
Entity type:Organization
Organization Name:ROOTS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:MAHMOUD
Authorized Official - Last Name:SALH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-824-5619
Mailing Address - Street 1:184 POMPTON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-3016
Mailing Address - Country:US
Mailing Address - Phone:973-779-3771
Mailing Address - Fax:
Practice Address - Street 1:184 POMPTON AVE FL 1
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-3016
Practice Address - Country:US
Practice Address - Phone:973-779-3771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty