Provider Demographics
NPI:1386215424
Name:ISMAIL, SULEMAN ZAREEF (DMD)
Entity Type:Individual
Prefix:DR
First Name:SULEMAN
Middle Name:ZAREEF
Last Name:ISMAIL
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 1:1601 N CLINTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-8551
Mailing Address - Country:US
Mailing Address - Phone:248-798-0342
Mailing Address - Fax:
Practice Address - Street 1:1601 N CLINTON ST STE A
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-8551
Practice Address - Country:US
Practice Address - Phone:419-789-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN259961223G0001X
OH30.0265931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice