Provider Demographics
NPI:1306440748
Name:HOROZINSKI, KIMMEUY (DMD)
Entity type:Individual
Prefix:DR
First Name:KIMMEUY
Middle Name:
Last Name:HOROZINSKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5001
Mailing Address - Country:US
Mailing Address - Phone:941-493-7768
Mailing Address - Fax:
Practice Address - Street 1:1900 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5001
Practice Address - Country:US
Practice Address - Phone:941-493-7768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH21464124Q00000X
FLDN290491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No124Q00000XDental ProvidersDental Hygienist