Provider Demographics
NPI:1174842991
Name:SOLEIMANI, KIMBERLY (KIMBERLY SOLEIMANI)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:SOLEIMANI
Suffix:
Gender:F
Credentials:KIMBERLY SOLEIMANI
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:SOLEIMANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:6 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2816
Mailing Address - Country:US
Mailing Address - Phone:516-298-8922
Mailing Address - Fax:
Practice Address - Street 1:2265 HALYARD DR
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5526
Practice Address - Country:US
Practice Address - Phone:516-298-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDO NOT KNOW1223P0221X
NY0560491223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry