Provider Demographics
NPI:1851419980
Name:WALEED SOLIMAN DENTAL CORP
Entity Type:Organization
Organization Name:WALEED SOLIMAN DENTAL CORP
Other - Org Name:BRITE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALEED
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-478-7221
Mailing Address - Street 1:4661 PRECISSI LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6222
Mailing Address - Country:US
Mailing Address - Phone:209-478-7221
Mailing Address - Fax:209-478-7297
Practice Address - Street 1:4661 PRECISSI LN
Practice Address - Street 2:SUITE A
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6222
Practice Address - Country:US
Practice Address - Phone:209-478-7221
Practice Address - Fax:209-478-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92497 01Medicaid