MEDICARE: DANIEL SULTAN DDS, MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	22DI02760700	NJ
2	208600000X	Surgery Physician	25MA11723200	NJ
3	390200000X	Student in an Organized Health Care Education/Training Program
4	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	22DI02760700	NJ
5	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	062002	NY
6	208600000X	Surgery Physician	307581	NY
7	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	062002	NY

General Provider Information

NPI Number	:	1427449990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL SULTAN DDS, MD

Provider Business Mailing Address
First Line	:	95 DANA PL
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-3629
Country	:	US
Telephone Number	:	631-379-0903
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST STE 2-A8
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5892
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2015
Last Update Date	:	12/16/2025

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