MEDICARE: SOHEIL ALEXANDER SOLEIMANI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	37922	CA

General Provider Information

NPI Number	:	1699950949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOHEIL ALEXANDER SOLEIMANI DDS

Provider Business Mailing Address
First Line	:	4411 REDONDO BEACH BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3465
Country	:	US
Telephone Number	:	310-338-0444
Fax Number	:	424-398-0156

Provider Business Practice Location Address
First Line	:	5795 WASHINGTON BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-7336
Country	:	US
Telephone Number	:	310-338-0444
Fax Number	:	424-398-0156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	01/19/2022

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