Healthcare Provider Details

I. General information

NPI: 1255410064
Provider Name (Legal Business Name): SUNIA ABDULA-LESSING D.D.S, M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 THOMAS JOHNSON DR SUITE 123
FREDERICK MD
21702-4361
US

IV. Provider business mailing address

12533 FOLLY QUARTER RD
ELLICOTT CITY MD
21042-1207
US

V. Phone/Fax

Practice location:
  • Phone: 301-668-3000
  • Fax: 301-668-7888
Mailing address:
  • Phone: 443-310-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number13195
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: