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General NPI Number Information
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NPI Number | 1316217540
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Entity Type | Individual
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Provider Name | ALEXIS LEE KLEINMAN DMD
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Gender | Female
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 2 EXECUTIVE PARK DR ALBANY OMS GROUP
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City | ALBANY
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State | NY
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Zip | 12203-3700
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Country | US
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Telephone | 518-446-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 19075 NW TANASBOURNE DRIVE #300 SUNSET DENTAL OFFICE
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City | HILLSBORO
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State | OR
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Zip | 97124-3700
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Country | US
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Telephone | 503-531-1700
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D10023
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License Number State | OR
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