Healthcare Provider Details

I. General information

NPI: 1174751044
Provider Name (Legal Business Name): ZINAIDA KALEINIKOVA DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 EUCLID AVE
CLEVELAND OH
44106-1712
US

IV. Provider business mailing address

186 BURWICK RD
CLEVELAND OH
44143-3825
US

V. Phone/Fax

Practice location:
  • Phone: 216-368-3565
  • Fax:
Mailing address:
  • Phone: 614-657-9655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number30-022964
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: