Provider Demographics
NPI:1841322955
Name:SUNDRANI, ASIM SULTAN (DDS)
Entity type:Individual
Prefix:
First Name:ASIM
Middle Name:SULTAN
Last Name:SUNDRANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 BARKER CYPRESS RD
Mailing Address - Street 2:SUITE # 800
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-8325
Mailing Address - Country:US
Mailing Address - Phone:281-225-9906
Mailing Address - Fax:832-349-9900
Practice Address - Street 1:12320 BARKER CYPRESS RD
Practice Address - Street 2:SUITE # 800
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-8325
Practice Address - Country:US
Practice Address - Phone:281-225-9906
Practice Address - Fax:832-349-9900
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice