Healthcare Provider Details

I. General information

NPI: 1790694693
Provider Name (Legal Business Name): SULOVARI DENTAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 BERGENLINE AVE FL 2
UNION CITY NJ
07087-5153
US

IV. Provider business mailing address

4801 BERGENLINE AVE FL 2
UNION CITY NJ
07087-5153
US

V. Phone/Fax

Practice location:
  • Phone: 201-865-6740
  • Fax: 201-865-6739
Mailing address:
  • Phone: 201-865-6740
  • Fax: 201-865-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VIKTOR SULOVARI
Title or Position: OWNER
Credential: DMD
Phone: 551-236-7534