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General NPI Number Information
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NPI Number | 1891869814
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Entity Type | Individual
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Provider Name | OMAR F. SUAREZ D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 800 2ND AVE RM 812
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City | NEW YORK
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State | NY
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Zip | 10017-9222
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Country | US
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Telephone | 973-589-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 245 WAYNE AVE
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-2607
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Country | US
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Telephone | 201-264-0200
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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 | 22DI01462000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI01462000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 042834
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number | 042834
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License Number State | NY
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