Individual provider Active NPI

Evelyn Sulaiman

  • Pediatric Dentistry
  • Philadelphia, PA
National Provider Identifier
1043984099
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS043152 Issued in PA
Practice address
2301 E Allegheny Ave
Philadelphia, PA 19134-4427
Phone
(215) 282-8000
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS043152 PA
Pediatric Dentistry 1223P0221X DS043152 PA Primary

Addresses

Primary practice location

2301 E Allegheny Ave
Philadelphia, PA 19134-4427

Mailing address

300 Village Dr Apt 759
King of Prussia, PA 19406-2892
Phone (610) 937-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811003261 PA Order and Referring Only - DentistPractitioner - Dentist 0244634327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS043152PAMDPediatric Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1043984099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VILLAGE DR APT 759",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062892",
            "telephone_number": "610-937-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344427",
            "telephone_number": "215-282-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAIMAN",
        "first_name": "EVELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043152",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS043152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.