Active NPI
Igor Sulim Jr., DDS
- Dentist
- Glendale, WI
National Provider Identifier
1316415086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1001926
- Practice address
- 2300 W Good Hope Rd Unit 337
Glendale, WI 53209-2749 - Phone
- (414) 630-2236
- NPI assigned
- Nov 10, 2018
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 1001926 | WI | Primary |
Addresses
Primary practice location
2300 W Good Hope Rd Unit 337
Glendale, WI 53209-2749
Mailing address
2300 W Good Hope Rd Unit 337
Glendale, WI 53209-2749
Phone (414) 630-2236
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 |
|---|---|---|---|
| 1001926 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Janesville Endodontics | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endodontics
- Janesville, WI
- NPI 1891319273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541808000000",
"number": "1316415086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 W GOOD HOPE RD UNIT 337",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532092749",
"telephone_number": "414-630-2236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 W GOOD HOPE RD UNIT 337",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532092749",
"telephone_number": "414-630-2236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULIM",
"first_name": "IGOR",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-10",
"last_updated": "2018-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1001926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.