Provider Demographics
NPI:1558698290
Name:SUTHERLAND, STEVEN JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:SUTHERLAND
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 1:23326 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3725
Mailing Address - Country:US
Mailing Address - Phone:310-378-8209
Mailing Address - Fax:310-375-1718
Practice Address - Street 1:23326 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3725
Practice Address - Country:US
Practice Address - Phone:310-378-8209
Practice Address - Fax:310-375-1718
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43862122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist