Provider Demographics
NPI:1861495400
Name:SOLTANI, SHANAZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHANAZ
Middle Name:
Last Name:SOLTANI
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:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-0097
Mailing Address - Country:US
Mailing Address - Phone:256-492-0131
Mailing Address - Fax:
Practice Address - Street 1:12062 AL HIGHWAY 227
Practice Address - Street 2:
Practice Address - City:GERALDINE
Practice Address - State:AL
Practice Address - Zip Code:35974-3562
Practice Address - Country:US
Practice Address - Phone:256-659-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4792122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist