Active NPI
Ethan Suh, DDS
- Dentist
- Sealy, TX
National Provider Identifier
1003441890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 35774
- Practice address
- 430 Meyer St
Sealy, TX 77474-2744 - Phone
- (979) 399-8267
- NPI assigned
- Mar 11, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35774 | TX | |
| Dentist | 122300000X | 35774 | TX | Primary |
Addresses
Primary practice location
430 Meyer St
Sealy, TX 77474-2744
Mailing address
24151 Bella Dolce LN Apt 609
Katy, TX 77494-7906
Phone (214) 790-4691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35774 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610323200000",
"number": "1003441890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24151 BELLA DOLCE LN APT 609",
"city": "KATY",
"state": "TX",
"postal_code": "774947906",
"telephone_number": "214-790-4691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 MEYER ST",
"city": "SEALY",
"state": "TX",
"postal_code": "774742744",
"telephone_number": "979-399-8267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUH",
"first_name": "ETHAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-11",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35774",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "35774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sealy, TX
- Melissa Mae Sims, CHW
- Skeletal Diagnostics of Sealy
- Kenneth Jay Smothers, M. ED., L.P.C.
- Specialty Hearing LLC
- St. Charles Health Care
- Suni Care Inc (County EMS)
- Tara Healthcare LLC
- Texas Dental Orthodontics Practice, PLLC (Sealy Dental)
- Texas Dental Specialist Practice, PLLC (Sealy Dental)
- The Center for Pursuit (Willow River Farms #12)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.