Provider Demographics
NPI:1154744126
Name:SOHEIL A SOLEIMANI DENTAL CORP
Entity type:Organization
Organization Name:SOHEIL A SOLEIMANI DENTAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-338-0444
Mailing Address - Street 1:4411 REDONDO BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3465
Mailing Address - Country:US
Mailing Address - Phone:310-802-6961
Mailing Address - Fax:
Practice Address - Street 1:1080 E WASHINGTON ST STE B
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-4185
Practice Address - Country:US
Practice Address - Phone:310-338-0444
Practice Address - Fax:424-398-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty