Provider Demographics
NPI:1629291786
Name:SUTHERLAND, LYNNE (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 ASHFORD GLEN LN
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1682
Mailing Address - Country:US
Mailing Address - Phone:330-285-4428
Mailing Address - Fax:
Practice Address - Street 1:790 ARLINGTON RIDGE
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44319
Practice Address - Country:US
Practice Address - Phone:330-644-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300188941223P0300X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0300XDental ProvidersDentistPeriodontics