Provider Demographics
NPI:1558254904
Name:SOSA LLULL, ANISMARY (DMD)
Entity type:Individual
Prefix:
First Name:ANISMARY
Middle Name:
Last Name:SOSA LLULL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 HARRISON AVE APT 2J
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-1909
Mailing Address - Country:US
Mailing Address - Phone:305-890-3928
Mailing Address - Fax:305-890-3928
Practice Address - Street 1:400 HARRISON AVE STE 201
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-1720
Practice Address - Country:US
Practice Address - Phone:973-484-0979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03094200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist