Healthcare Provider Details

I. General information

NPI: 1285562207
Provider Name (Legal Business Name): DR SULTAN DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E WEND ST STE B
LEMONT IL
60439-2904
US

IV. Provider business mailing address

1 REGENT DR
OAK BROOK IL
60523-1728
US

V. Phone/Fax

Practice location:
  • Phone: 630-257-8669
  • Fax:
Mailing address:
  • Phone: 215-439-2516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ASAD TANVIR
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 215-439-2516