Provider Demographics
NPI:1578152302
Name:SALIM, HARITH
Entity type:Individual
Prefix:
First Name:HARITH
Middle Name:
Last Name:SALIM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31581 CANYON ESTATES DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0412
Mailing Address - Country:US
Mailing Address - Phone:619-383-5469
Mailing Address - Fax:
Practice Address - Street 1:31581 CANYON ESTATES DR STE 201
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0412
Practice Address - Country:US
Practice Address - Phone:619-383-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105942122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist