Provider Demographics
NPI:1649639816
Name:SULAIMAN, MUNIRA
Entity type:Individual
Prefix:
First Name:MUNIRA
Middle Name:
Last Name:SULAIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3121
Mailing Address - Country:US
Mailing Address - Phone:609-779-2054
Mailing Address - Fax:
Practice Address - Street 1:335 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-3121
Practice Address - Country:US
Practice Address - Phone:609-779-2054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI026370001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649639816OtherNPPES