Provider Demographics
NPI:1366454266
Name:GUIRGUIS, SOLIMAN K (DDS)
Entity Type:Individual
Prefix:
First Name:SOLIMAN
Middle Name:K
Last Name:GUIRGUIS
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 1:45 54 41 STREET
Mailing Address - Street 2:APT #1C
Mailing Address - City:LIC
Mailing Address - State:NY
Mailing Address - Zip Code:11104
Mailing Address - Country:US
Mailing Address - Phone:718-784-0332
Mailing Address - Fax:718-433-4844
Practice Address - Street 1:45 54 41 STREET
Practice Address - Street 2:APT #1C
Practice Address - City:LIC
Practice Address - State:NY
Practice Address - Zip Code:11104
Practice Address - Country:US
Practice Address - Phone:718-784-0332
Practice Address - Fax:718-433-4844
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031376122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00286186Medicaid