Provider Demographics
NPI:1295822039
Name:SHULMAN, STANLEY EDWARD (DDS)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:EDWARD
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 MASSACHUSETTS AVENUE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4313
Mailing Address - Country:US
Mailing Address - Phone:202-966-3100
Mailing Address - Fax:202-537-1622
Practice Address - Street 1:5002 MASSACHUSETTS AVENUE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4313
Practice Address - Country:US
Practice Address - Phone:202-966-3100
Practice Address - Fax:202-537-1622
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN32841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice