Marissa Anne Sulich, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901601007 Issued in MI

Practice address

4501 24 Mile Rd Ste a
Shelby Township, MI 48316-3005

Phone

(586) 263-4720

NPI assigned

Jun 19, 2021

Last updated

Jun 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MGM Dental

  • Dentist
  • Clinton TWP, MI
  • NPI 1306910930
  NPD (past)

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1871162388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 GOLFVIEW DR APT 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 24 MILE RD STE A",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163005",
            "telephone_number": "586-263-4720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39400 Garfield Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480384096",
            "country_code": "US",
            "telephone_number": "248-568-2660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULICH",
        "first_name": "MARISSA",
        "middle_name": "ANNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Kimberly Stritt
• Katlynn Frances Strnad
• Pamela Gail Strong
• Michael S Su, DDS
• Kaus Sulaka
• Mark Robert Sullivan, DDS
• Rachel Sullivan, LPC
• Summit Sleep Center, PLLC
• Supplemental Nursing Services Inc
• Maureen Nicole Sutter, R.D.H

• Dentist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; 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.