Active NPI
Maxim Sulla, D.D.S.
- Pediatric Dentistry
- North Brunswick, NJ
National Provider Identifier
1720007776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DI21205
- Practice address
- 1330 How LN
North Brunswick, NJ 08902-1702 - Phone
- (732) 249-1010
- Fax
- (732) 220-0177
- NPI assigned
- Jul 19, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DI21205 | 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
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 |
|---|---|---|---|
| DI21205 | NJ | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tender Smiles of Ocean PA | Pediatric Dentistry | Current | Accepting new patients |
| Tender Smiles of Roselle PA | Pediatric Dentistry | Current | Accepting new patients |
| Tender Smiles of Old Bridge PA | Current | Accepting new patients | |
| Tender Smiles of Edison PA | Pediatric Dentistry | Past | Accepting new patients |
| Tender Smiles 4 Kids of Monmouth, LLC | Pediatric Dentistry | Past | Accepting new patients |
Locations
105 Berkeley Ave
Ocean, NJ 07712
Phone (732) 774-7007
3333 US Highway 9
Old Bridge, NJ 08857
Phone (732) 679-6666
2209 Wood Ave
Roselle, NJ 07203
Phone (908) 245-5556
Organizations & group practices 5
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.
-
- Pediatric Dentistry
- Ocean, NJ
- NPI 1265000673
-
- Dentist
- Old Bridge, NJ
- NPI 1851264014
-
- Pediatric Dentistry
- Linden, NJ
- NPI 1063999506
-
- Pediatric Dentistry
- Freehold, NJ
- NPI 1942315445
-
- Pediatric Dentistry
- Edison, NJ
- NPI 1528326543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1720007776",
"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": {
"last_name": "SULLA",
"first_name": "MAXIM",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "DI21205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.