Provider Demographics
NPI:1144418575
Name:SULIMAN, SAM NAZIH (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:NAZIH
Last Name:SULIMAN
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4534 PRECISSI LN STE C
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207
Mailing Address - Country:US
Mailing Address - Phone:209-478-5167
Mailing Address - Fax:209-478-2313
Practice Address - Street 1:320 S CHEROKEE LN
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-4266
Practice Address - Country:US
Practice Address - Phone:209-339-7101
Practice Address - Fax:209-478-2313
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist