Provider Demographics
NPI:1639536402
Name:KLEYMAN, DENADA (DDS)
Entity type:Individual
Prefix:
First Name:DENADA
Middle Name:
Last Name:KLEYMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 RIVER RD
Mailing Address - Street 2:APT 908
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1358
Mailing Address - Country:US
Mailing Address - Phone:917-691-6235
Mailing Address - Fax:
Practice Address - Street 1:1077 RIVER RD
Practice Address - Street 2:APT 908
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1358
Practice Address - Country:US
Practice Address - Phone:917-691-6235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026104001223G0001X
NY0582501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice