Active NPI
Jimmy Nazih Suliman, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Groton, CT
National Provider Identifier
1063027407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 105509
- Practice address
- 1 Wahoo Ave
Groton, CT 06349-2324 - Phone
- (860) 694-3738
- NPI assigned
- Sep 12, 2020
- Last updated
- Sep 25, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 105509 | CA | Primary |
Addresses
Primary practice location
1 Wahoo Ave
Groton, CT 06349-2324
Mailing address
702 Pleasant Valley Rd N Apt 101
Groton, CT 06340-2554
Phone (209) 817-1929
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105509 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790294400000",
"number": "1063027407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 PLEASANT VALLEY RD N APT 101",
"city": "GROTON",
"state": "CT",
"postal_code": "063402554",
"telephone_number": "209-817-1929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WAHOO AVE",
"city": "GROTON",
"state": "CT",
"postal_code": "063492324",
"telephone_number": "860-694-3738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULIMAN",
"first_name": "JIMMY",
"middle_name": "NAZIH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-12",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "105509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Groton, CT
- Stonington Behavioral Health Inc (Stonington Institute)
- Stop & Shop Supermarket Company LLC (Stop and Shop Pharmacy #682)
- Kenderick Renard Street Jr., IDC
- Mary Suarez
- Timothy Edward Suarez, PHARMD
- Daniel Patrick Sullivan, SUBMARINE IDC
- Darien Sun
- Konrad Edward Surdel, DO
- Patricia R Swim, NP-C
- Samantha Swistak, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.