=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598803108
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OSCAR RAUL SUAREZ-SANCHEZ DDS., MSCD, MMSC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2007
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 991 W HUDSON BLVD
-----------------------------------------------------
City | GASTONIA
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28052-6430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-853-5191
-----------------------------------------------------
Fax | 704-853-5131
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1829 S RIDGE AVE
-----------------------------------------------------
City | KANNAPOLIS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28083-6149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-279-6045
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0700X
-----------------------------------------------------
Taxonomy Name | Prosthodontics
-----------------------------------------------------
License Number | DE00009647
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223P0700X
-----------------------------------------------------
Taxonomy Name | Prosthodontics
-----------------------------------------------------
License Number | 13635
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------