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General NPI Number Information
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NPI Number | 1730473349
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Entity Type | Organization
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Legal Business Name | EDWARD Y.JIMENEZ D.D.S. INC
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 7055 ENGLE RD STE 501
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City | CLEVELAND
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State | OH
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Zip | 44130-8491
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Country | US
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Telephone | 440-243-1600
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Fax | 440-243-1604
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Provider Business Mailing Address
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Address Line | 7055 ENGLE RD STE 501
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City | CLEVELAND
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State | OH
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Zip | 44130-8491
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Country | US
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Telephone | 440-243-1600
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Fax | 440-243-1604
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD Y. JIMENEZ
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Credential | D.D.S.
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Telephone | 440-243-1600
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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 |
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License Number State |
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