Provider Demographics
NPI:1295611275
Name:BELAYET, SUMMER SHIRIN (DMD)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:SHIRIN
Last Name:BELAYET
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 1:9514 HILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-7979
Mailing Address - Country:US
Mailing Address - Phone:414-204-2362
Mailing Address - Fax:
Practice Address - Street 1:138 JUNCTION RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2687
Practice Address - Country:US
Practice Address - Phone:608-833-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001948-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice