Provider Demographics
NPI:1447258991
Name:KALEEL, NICHOLAS GEORGE (DMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:GEORGE
Last Name:KALEEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N CONGRESS AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3469
Mailing Address - Country:US
Mailing Address - Phone:561-736-9997
Mailing Address - Fax:561-736-3800
Practice Address - Street 1:555 N CONGRESS AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3469
Practice Address - Country:US
Practice Address - Phone:561-736-9997
Practice Address - Fax:561-736-3800
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 9870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL67499OtherBLUECROSS/BLUESHIELD
FL53149-1OtherUNITED HEALTHCARE INS. CO
FL530204OtherUNITED CONCORDIA INS. CO.
FL530204OtherUNITED CONCORDIA INS. CO.