Provider Demographics
NPI:1528105483
Name:JEFFREY L KLEINMAN DDS, LLC
Entity type:Organization
Organization Name:JEFFREY L KLEINMAN DDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KLEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-278-7954
Mailing Address - Street 1:3609 N DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-5232
Mailing Address - Country:US
Mailing Address - Phone:937-278-7954
Mailing Address - Fax:937-278-8232
Practice Address - Street 1:3609 N DIXIE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-5232
Practice Address - Country:US
Practice Address - Phone:937-278-7954
Practice Address - Fax:937-278-8232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty