Individual
EDAN SOLEIMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 TIDEWAY ST, GREAT NECK, NY 11024-1118
(516) 749-8565
Mailing address
11 TIDEWAY ST, GREAT NECK, NY 11024-1118
(516) 749-8565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06423101
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2023
Last updated
11/17/2025
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