Provider Demographics
NPI:1508508912
Name:ANDY SUH, DMD, LLC
Entity Type:Organization
Organization Name:ANDY SUH, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-270-9605
Mailing Address - Street 1:6221 UPPER ALBANY CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7566
Mailing Address - Country:US
Mailing Address - Phone:714-270-9605
Mailing Address - Fax:
Practice Address - Street 1:555 W SCHROCK RD STE 130
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8739
Practice Address - Country:US
Practice Address - Phone:714-270-9605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty