Provider Demographics
NPI:1114168978
Name:SUSHYNSKI, JOHN MICHAEL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:SUSHYNSKI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S LINDEN RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-4073
Mailing Address - Country:US
Mailing Address - Phone:810-733-5310
Mailing Address - Fax:810-733-1216
Practice Address - Street 1:1125 S LINDEN RD
Practice Address - Street 2:SUITE 800
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4073
Practice Address - Country:US
Practice Address - Phone:810-733-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010199601223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry