Provider Demographics
NPI:1841041183
Name:AL SUMAIRI, JUMANAH
Entity type:Individual
Prefix:
First Name:JUMANAH
Middle Name:
Last Name:AL SUMAIRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 E MCDOWELL RD APT 1023
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3553
Mailing Address - Country:US
Mailing Address - Phone:602-477-9039
Mailing Address - Fax:
Practice Address - Street 1:1838 W BELL RD STE 109
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-3481
Practice Address - Country:US
Practice Address - Phone:602-641-5818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0119881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice