Provider Demographics
NPI:1891107280
Name:SOUMEEH, NIKI KATOOZI (DDS)
Entity type:Individual
Prefix:MS
First Name:NIKI
Middle Name:KATOOZI
Last Name:SOUMEEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 S EUCLID AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-6684
Mailing Address - Country:US
Mailing Address - Phone:909-391-4300
Mailing Address - Fax:
Practice Address - Street 1:2905 S EUCLID AVE STE D
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-6684
Practice Address - Country:US
Practice Address - Phone:909-391-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62516122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist