Audrey Lynn Sookoo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30023459 Issued in OH

Practice address

444 Graham Rd
Cuyahoga Falls, OH 44221-1302

Phone

(330) 923-9944

NPI assigned

Jun 11, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Audrey Lynn Kosik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1013237114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211302",
            "telephone_number": "330-923-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211302",
            "telephone_number": "330-923-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOKOO",
        "first_name": "AUDREY",
        "middle_name": "LYNN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30023459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "KOSIK",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ericka Solomon, DODD IP
• Rosa Sharon Somerville, LMT
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• Kathryn Soudry, M.A.
• Dmitri Souza, M.D., PH.D.
• Spectrum Developmental Services, Incorporated
• Brittany Spencer, OTR/L

• General Practice Dentistry in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.