Provider Demographics
NPI:1083826895
Name:KIAIE, VALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALI
Middle Name:
Last Name:KIAIE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BELGIUM
Mailing Address - State:WI
Mailing Address - Zip Code:53004-9715
Mailing Address - Country:US
Mailing Address - Phone:262-285-3408
Mailing Address - Fax:262-285-4025
Practice Address - Street 1:171 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:BELGIUM
Practice Address - State:WI
Practice Address - Zip Code:53004-9715
Practice Address - Country:US
Practice Address - Phone:262-285-3408
Practice Address - Fax:262-285-4025
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3504151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice