Provider Demographics
NPI:1922565084
Name:AL AMEEN, REEM NAZARJASIM (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:REEM
Middle Name:NAZARJASIM
Last Name:AL AMEEN
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 S GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1479
Mailing Address - Country:US
Mailing Address - Phone:314-828-0912
Mailing Address - Fax:
Practice Address - Street 1:4071 LEE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-2100
Practice Address - Country:US
Practice Address - Phone:314-828-0912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0262811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice