Steven D Sudbrink, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN24404 Issued in FL

Practice address

800 Grandview Dr
Ephrata, PA 17522-1635

Phone

(717) 733-8645

Fax

(717) 733-9172

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1164514402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20726 SABAL ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328335624",
            "telephone_number": "717-314-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRANDVIEW DR",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221635",
            "telephone_number": "717-733-8645",
            "fax_number": "717-733-9172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Park Center Dr Ste 125",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328357610",
            "country_code": "US",
            "telephone_number": "321-273-5188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDBRINK",
        "first_name": "STEVEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS028494L",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS028494L",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN24404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel E Stoltzfus Jr., CRNP
• Timothy Robert Stow, LPC
• Joseph William Strangarity, M.D.
• Dirk Strasser, MD
• Mandy Stull, DO
• Pierre Walter Suhrbier, D.C.
• Supports Coordination Group, LLC
• Regina Marie Suydam, LMT
• Kevin Sweeney, DO
• Jayden Alexa Sweigart, CPHT

• Oral and Maxillofacial Surgery (Dentist) in Ephrata, PA
• Providers in Ephrata, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.