Provider Demographics
NPI:1992823942
Name:SANUSI, JEMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEMI
Middle Name:
Last Name:SANUSI
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 1:707 NARROWLEAF DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:301-499-3861
Mailing Address - Fax:
Practice Address - Street 1:1400 MERCANTILE LN
Practice Address - Street 2:SUITE 224
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:301-341-2131
Practice Address - Fax:301-341-2131
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice