Provider Demographics
NPI:1497828974
Name:KREITMAN, RIKI TAMARA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RIKI
Middle Name:TAMARA
Last Name:KREITMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2621
Mailing Address - Country:US
Mailing Address - Phone:732-572-3226
Mailing Address - Fax:
Practice Address - Street 1:34 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2621
Practice Address - Country:US
Practice Address - Phone:732-572-3226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI174371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice