Provider Demographics
NPI:1790911105
Name:ACHAR, SUMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUMA
Middle Name:
Last Name:ACHAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8435 STATION ST
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4924
Mailing Address - Country:US
Mailing Address - Phone:440-255-3111
Mailing Address - Fax:440-255-8275
Practice Address - Street 1:8435 STATION ST
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4924
Practice Address - Country:US
Practice Address - Phone:440-255-3111
Practice Address - Fax:440-255-8275
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0212151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice