Provider Demographics
NPI:1124495015
Name:SOLOMON, FREDERICK (DMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:SOLOMON
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 1:44 LISPENARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2550
Mailing Address - Country:US
Mailing Address - Phone:212-473-4444
Mailing Address - Fax:212-473-4477
Practice Address - Street 1:44 LISPENARD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2550
Practice Address - Country:US
Practice Address - Phone:212-473-4444
Practice Address - Fax:212-473-4477
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044174122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist