Provider Demographics
NPI:1306979307
Name:KAPILA, SUNIL D (DDS MS PHD)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:D
Last Name:KAPILA
Suffix:
Gender:M
Credentials:DDS MS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1078
Mailing Address - Country:US
Mailing Address - Phone:734-764-1522
Mailing Address - Fax:734-763-8100
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1078
Practice Address - Country:US
Practice Address - Phone:734-764-1522
Practice Address - Fax:734-763-8100
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019026122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1958112030OtherBCBS OF MI MED SURG
MI4828371Medicaid
MI4828362Medicaid
MID190260OtherBCBS OF MI DENTAL
MI4828362Medicaid