Provider Demographics
NPI:1326106485
Name:SUEZAKI, ROBERT ITO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ITO
Last Name:SUEZAKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SUTTER STREET
Mailing Address - Street 2:SUITE 1814
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108
Mailing Address - Country:US
Mailing Address - Phone:415-421-1814
Mailing Address - Fax:415-421-1850
Practice Address - Street 1:450 SUTTER STREET
Practice Address - Street 2:SUITE 1814
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:415-421-1814
Practice Address - Fax:415-421-1850
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA342271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA34227OtherLICENSE
CA34227OtherLICENSE