Provider Demographics
NPI:1386901262
Name:KLEYMAN, BORIS (DDS)
Entity type:Individual
Prefix:
First Name:BORIS
Middle Name:
Last Name:KLEYMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25-15 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3813
Mailing Address - Country:US
Mailing Address - Phone:732-803-1948
Mailing Address - Fax:
Practice Address - Street 1:25-15 BROADWAY
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3813
Practice Address - Country:US
Practice Address - Phone:732-803-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD153701223G0001X
DCDEN10011291223G0001X
NJ22DI026000001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice