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1952498263 NPI number — JAY S. SUAVERDEZ DDS

NPI Number: 1952498263
Health Care Provider/Practitioner: JAY S. SUAVERDEZ DDS

Information about “1952498263” NPI (JAY S. SUAVERDEZ DDS) exists in 1952498263 in HTML format HTML  |  1952498263 in plain Text format TXT  |  1952498263 in PDF (Portable Document Format) PDF  |  1952498263 in an XML format XML  formats.

NPI Number : 1952498263 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952498263",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SUAVERDEZ",
    "FirstName": "JAY",
    "MiddleName": "S.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SUAVERDEZ",
    "OtherFirstName": "SESINANDO",
    "OtherMiddleName": "P.",
    "OtherNamePrefix": null,
    "OtherNameSuffix": "II",
    "OtherCredential": "DDS",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "14441 W. MCDOWELL RD",
    "SecondLineMailingAddress": "B106",
    "MailingAddressCityName": "GOODYEAR",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85395",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "623-536-3264",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1631 N. 144TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GOODYEAR",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85395",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-505-9243",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/06/2006",
    "LastUpdateDate": "08/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "5831",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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