Healthcare Provider Details

I. General information

NPI: 1356071120
Provider Name (Legal Business Name): SIJAL SALEEM DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CONCORDE WAY BLDG 1
WINDSOR LOCKS CT
06096-1577
US

IV. Provider business mailing address

2 CONCORDE WAY BLDG 1
WINDSOR LOCKS CT
06096-1577
US

V. Phone/Fax

Practice location:
  • Phone: 860-623-3244
  • Fax:
Mailing address:
  • Phone: 860-623-3244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13736
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: