Healthcare Provider Details

I. General information

NPI: 1013734375
Provider Name (Legal Business Name): LAYAN SULEIMAN BDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28411 NORTHWESTERN HWY STE 115
SOUTHFIELD MI
48034-5536
US

IV. Provider business mailing address

28411 NORTHWESTERN HWY STE 115
SOUTHFIELD MI
48034-5536
US

V. Phone/Fax

Practice location:
  • Phone: 248-636-2005
  • Fax: 248-636-2006
Mailing address:
  • Phone: 248-636-2005
  • Fax: 248-636-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number2901602357
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: