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General NPI Number Information
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NPI Number | 1144508441
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Entity Type | Individual
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Provider Name | SHAHENAZ SULIMAN DMD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 11707 LAKEWOOD DR
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City | HUDSON
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State | FL
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Zip | 34669-2906
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Country | US
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Telephone | 727-379-9250
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Fax | 727-856-9250
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Provider Business Mailing Address
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Address Line | 207 8TH ST E
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City | ST PETERSBURG
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State | FL
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Zip | 33715-2248
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Country | US
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Telephone | 727-379-9250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 60604
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN14950
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License Number State | FL
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