Provider Demographics
NPI:1609979020
Name:HENRY A SUAREZ DDS INC
Entity Type:Organization
Organization Name:HENRY A SUAREZ DDS INC
Other - Org Name:FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-997-7797
Mailing Address - Street 1:15355 SHERMAN WAY STE K
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4200
Mailing Address - Country:US
Mailing Address - Phone:818-997-7797
Mailing Address - Fax:818-762-8849
Practice Address - Street 1:15355 SHERMAN WAY STE K
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4200
Practice Address - Country:US
Practice Address - Phone:818-997-7797
Practice Address - Fax:818-762-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty