Provider Demographics
NPI:1245945252
Name:MUJHID, SURA (DDS)
Entity type:Individual
Prefix:
First Name:SURA
Middle Name:
Last Name:MUJHID
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 1:20603 KYNDALLS JOY CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5273
Mailing Address - Country:US
Mailing Address - Phone:346-818-0324
Mailing Address - Fax:
Practice Address - Street 1:20603 KYNDALLS JOY CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5273
Practice Address - Country:US
Practice Address - Phone:346-818-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39121122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist