MEDICARE: DR. HANNAH SUTHERLAND DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	39427	TX

General Provider Information

NPI Number	:	1487213955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANNAH SUTHERLAND DDS

Provider Business Mailing Address
First Line	:	4464 STONEGATE DR APT G
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45430-6602
Country	:	US
Telephone Number	:	941-773-1561
Fax Number	:

Provider Business Practice Location Address
First Line	:	9703 BANDERA RD STE 210
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5622
Country	:	US
Telephone Number	:	210-864-0086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	12/20/2023

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