Provider Demographics
NPI:1649492521
Name:SOLEYMANI, KEYVAN (DMD)
Entity type:Individual
Prefix:DR
First Name:KEYVAN
Middle Name:
Last Name:SOLEYMANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 7TH AVE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-1863
Mailing Address - Country:US
Mailing Address - Phone:205-322-5437
Mailing Address - Fax:205-322-5504
Practice Address - Street 1:1520 7TH AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-1863
Practice Address - Country:US
Practice Address - Phone:205-322-5437
Practice Address - Fax:205-322-5504
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist