Provider Demographics
NPI:1356684062
Name:SUAREZ-TIBURCIO, ANA (DDS)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:SUAREZ-TIBURCIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:LUISA
Other - Last Name:SUAREZ-COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:22 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2104
Mailing Address - Country:US
Mailing Address - Phone:646-284-3384
Mailing Address - Fax:
Practice Address - Street 1:22 MT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703
Practice Address - Country:US
Practice Address - Phone:646-284-3384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057612122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program