Suganya Nelatoor

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09619 Issued in NC

Practice address

102 Waxhaw Professional Park Dr Ste E
Waxhaw, NC 28173-5025

Phone

(704) 256-3548

Fax

(704) 256-3548

NPI assigned

Jul 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suganya Nelatoor,D.D.S.,P.L.L.C.

  • Dental Clinic/Center
  • Waxhaw, NC
  • NPI 1336631514
  NPD Authorized official
• Kids & Family Dental, P.C.

  • General Practice Dentistry
  • Manassas, VA
  • NPI 1689933582
  NPD (past)
• Small Smiles of Manassas, LLC

  • General Practice Dentistry
  • Manassas, VA
  • NPI 1780718676
  NPD (past)

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1124228713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WAXHAW PROFESSIONAL PARK DR STE E",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281735025",
            "telephone_number": "704-256-3548",
            "fax_number": "704-256-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WAXHAW PROFESSIONAL PARK DR STE E",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281735025",
            "telephone_number": "704-256-3548",
            "fax_number": "704-256-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELATOOR",
        "first_name": "SUGANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "09619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome Richard Myles, MA
• N Mahale DDS PLLC
• Naina Mahale DDS PLLC
• Goemie Narcisse, MOT, OTR/L
• Martie Badger Neel, PT
• Aikhanh Thuy Nguyen, PA-C
• Thao Phuong Nguyen, M.D.
• NHC Healthcare/Waxhaw, LLC
• Nicholas Niday, DC
• Daniela Nieves

• General Practice Dentistry in Waxhaw, NC
• Providers in Waxhaw, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.