NPIMap

Organization Active NPI

Maxim Sulla,DDS, Professional Association

Doing business as Tender Smiles 4 Kids

  • Pediatric Dentistry
  • North Brunswick, NJ
National Provider Identifier
1174540959
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Authorized official

Name
Maxim Sulla, D.D.S.NPI 1720007776
Title
Owner/President
Phone
(732) 249-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DI 21205 NJ Primary

Addresses

Primary practice location

1330 How LN
North Brunswick, NJ 08902-1702

Mailing address

1330 How LN
North Brunswick, NJ 08902-1702
Phone (732) 249-1010

Other names 1

  • Tender Smiles 4 Kids Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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"
        }
    ]
}

Other providers in North Brunswick, NJ

Sources for this page

  • 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.