Individual provider Active NPI

Manal Sunna, DDS

  • Pediatric Dentistry
  • Cleveland, OH
National Provider Identifier
1386894459
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30.023526 Issued in OH
Practice address
4163 Pearl Rd.
Cleveland, OH 44109-1900
Phone
(216) 862-4990
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2712 OH
Pediatric Dentistry 1223P0221X 30.023526 OH Primary

Addresses

Primary practice location

4163 Pearl Rd.
Cleveland, OH 44109-1900

Mailing address

4163 Pearl Rd
Cleveland, OH 44109-3332
Phone (216) 862-4990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120627000211 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7113182015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.023526OHMDPediatric Dentist
2712OHMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1386894459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4163 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093332",
            "telephone_number": "216-862-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4163 PEARL RD.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-862-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNNA",
        "first_name": "MANAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "2712",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.023526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.