Provider Demographics
NPI:1255596987
Name:SUH, JEFF (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:SUH
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3242
Mailing Address - Country:US
Mailing Address - Phone:914-713-4999
Mailing Address - Fax:914-713-8555
Practice Address - Street 1:1075 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3242
Practice Address - Country:US
Practice Address - Phone:914-713-4999
Practice Address - Fax:914-713-8555
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055287122300000X
NJ22DI02424900122300000X
CA57269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist