Provider Demographics
NPI:1710148259
Name:SKUJA, NUTHYLA SINADA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NUTHYLA
Middle Name:SINADA
Last Name:SKUJA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NUTHYLA
Other - Middle Name:GHAZI
Other - Last Name:SINADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:527 MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2634
Mailing Address - Country:US
Mailing Address - Phone:410-963-2847
Mailing Address - Fax:
Practice Address - Street 1:900 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390
Practice Address - Country:US
Practice Address - Phone:610-869-9727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414173122300000X
DC1001311122300000X
MD14971122300000X
ORD9989122300000X
CA1021661223P0221X
PADS0380961223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist