Provider Demographics
NPI:1265528608
Name:NAIMAN, ARKADY T (DMD)
Entity type:Individual
Prefix:
First Name:ARKADY
Middle Name:T
Last Name:NAIMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WILKENS DR STE 204
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-5019
Mailing Address - Country:US
Mailing Address - Phone:508-695-7674
Mailing Address - Fax:508-643-9189
Practice Address - Street 1:6 WILKENS DR STE 204
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-5019
Practice Address - Country:US
Practice Address - Phone:508-695-7674
Practice Address - Fax:508-643-9189
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA182171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA18217OtherLICENSE NUMBER
MA043259394OtherTAX ID NUMBER