Provider Demographics
NPI:1780761346
Name:GOODMAN, SUNDUS SINDY (DDS MS)
Entity type:Individual
Prefix:DR
First Name:SUNDUS
Middle Name:SINDY
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:DDS MS
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Mailing Address - Street 1:8050 GREENLAWN COURT
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382
Mailing Address - Country:US
Mailing Address - Phone:248-465-7500
Mailing Address - Fax:248-465-7501
Practice Address - Street 1:42430 WEST TWELVE MILE RD
Practice Address - Street 2:STE 101
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-4028
Practice Address - Country:US
Practice Address - Phone:248-465-7500
Practice Address - Fax:248-465-7501
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI2901016937122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics