Provider Demographics
NPI:1750567673
Name:STREEM, MINDY JILL (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:JILL
Last Name:STREEM
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:MINDY
Other - Middle Name:JILL
Other - Last Name:GREENBLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:34501 AURORA RD STE 305
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-3831
Mailing Address - Country:US
Mailing Address - Phone:440-248-4825
Mailing Address - Fax:440-248-5489
Practice Address - Street 1:34501 AURORA RD STE 305
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3831
Practice Address - Country:US
Practice Address - Phone:440-248-4825
Practice Address - Fax:440-248-5489
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0224781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics