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General NPI Number Information
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NPI Number | 1306307004
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Entity Type | Individual
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Provider Name | MICHAEL DAVID KLEEMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 7575 W 20TH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80214-5738
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Country | US
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Telephone | 303-238-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 55 GRASSLANDS CIR
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City | MOUNT SINAI
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State | NY
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Zip | 11766-1862
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Country | US
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Telephone | 631-275-4823
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN.00205415
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License Number State | CO
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