Provider Demographics
NPI:1861983231
Name:BRYSON, NINA NAJMA
Entity type:Individual
Prefix:MRS
First Name:NINA
Middle Name:NAJMA
Last Name:BRYSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NINA
Other - Middle Name:NAJMA
Other - Last Name:TOMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38951 RYAN ROAD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310
Mailing Address - Country:US
Mailing Address - Phone:586-978-8233
Mailing Address - Fax:
Practice Address - Street 1:38951 RYAN ROAD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:586-978-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist