Provider Demographics
NPI:1275747255
Name:RICARDO A. SUAREZ, D.D.S., INC.
Entity Type:Organization
Organization Name:RICARDO A. SUAREZ, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-919-4337
Mailing Address - Street 1:12423 CAMILLA ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-3306
Mailing Address - Country:US
Mailing Address - Phone:626-919-4337
Mailing Address - Fax:626-919-2300
Practice Address - Street 1:100 S VINCENT AVE STE 404
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2902
Practice Address - Country:US
Practice Address - Phone:626-919-4337
Practice Address - Fax:626-919-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty