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General NPI Number Information
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NPI Number | 1508331539
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Entity Type | Individual
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Provider Name | JOSEPH MANCINI SUSLIK DDS
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Gender | Male
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1555 S WADSWORTH BLVD STE 1
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City | LAKEWOOD
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State | CO
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Zip | 80232-6830
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Country | US
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Telephone | 303-986-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 6680 BALSAM ST
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City | ARVADA
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State | CO
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Zip | 80004-3316
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Country | US
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Telephone | 757-289-5758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401416095
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License Number State | VA
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