Healthcare Provider Details

I. General information

NPI: 1093633240
Provider Name (Legal Business Name): ARTUR MUKHLIKHANOV
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 NJ-138 #1A
WALL TOWNSHIP NJ
07719
US

IV. Provider business mailing address

1516 NJ-138 #1A
WALL TOWNSHIP NJ
07719
US

V. Phone/Fax

Practice location:
  • Phone: 732-681-5544
  • Fax:
Mailing address:
  • Phone: 732-681-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03152700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: