Provider Demographics
NPI:1659425775
Name:SIRILAN, NEMIE SAPATALO (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEMIE
Middle Name:SAPATALO
Last Name:SIRILAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 OAK TREE AVE
Mailing Address - Street 2:SUITE O
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5127
Mailing Address - Country:US
Mailing Address - Phone:908-753-5000
Mailing Address - Fax:908-753-0300
Practice Address - Street 1:906 OAK TREE AVE
Practice Address - Street 2:SUITE O
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5127
Practice Address - Country:US
Practice Address - Phone:908-753-5000
Practice Address - Fax:908-753-0300
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022035001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice