Provider Demographics
NPI:1619664208
Name:NUSAYR PLLC
Entity Type:Organization
Organization Name:NUSAYR PLLC
Other - Org Name:SOUTH SOUND ORAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSAYR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-481-4368
Mailing Address - Street 1:34709 9TH AVE S STE B300
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8715
Mailing Address - Country:US
Mailing Address - Phone:253-874-2583
Mailing Address - Fax:
Practice Address - Street 1:34709 9TH AVE S STE B300
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8715
Practice Address - Country:US
Practice Address - Phone:253-874-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes125Q00000XDental ProvidersOral MedicinistGroup - Single Specialty