Maxim Sulla,DDS, Professional Association

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI 21205 Issued in NJ

Legal business name

MAXIM SULLA,DDS, PROFESSIONAL ASSOCIATION

Doing business as

Tender Smiles 4 Kids

Practice address

1330 How LN
North Brunswick, NJ 08902-1702

Phone

(732) 249-1010

Fax

(732) 220-0177

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Maxim Sulla, D.D.S.

Title

Owner/President

Phone

(732) 249-1010

Specialties & licenses 1

Addresses

Other names 1

• Tender Smiles 4 Kids Doing business as

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1174540959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 HOW LN",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021702",
            "telephone_number": "732-249-1010",
            "fax_number": "732-220-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 HOW LN",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021702",
            "telephone_number": "732-249-1010",
            "fax_number": "732-220-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM SULLA,DDS, PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "SULLA",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "732-249-1010",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI 21205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tender Smiles 4 Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyssa Manning, CPRS
• John D Marr, D.D.S.
• Marsha N. Shapiro, LCSW, BCD, LLC
• Matthew T Furlong Jr LPC
• John W Maurer, PT, DPT
• Maximum Health & Wellness North Brunswick LLC
• Omar Francisco Mayorga, DMD
• Chrishonda Curry McCoy
• Tina F McGowan, Lac
• Shanique McGowan, LCSW

• Pediatric Dentistry in North Brunswick, NJ
• Providers in North Brunswick, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.