Jocelynn Vida Sustaita, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64080 Issued in CA

Practice address

141 E Willow St
Long Beach, CA 90806-2633

Phone

(702) 524-2466

NPI assigned

Oct 2, 2014

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

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1174926281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8137 DESERT JEWEL CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287741",
            "telephone_number": "702-524-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062633",
            "telephone_number": "702-524-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTAITA",
        "first_name": "JOCELYNN",
        "middle_name": "VIDA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sure Ride Senior Transportation
• Surgical Institute of California LLC
• Surgical Suite of Southern California, a Medical Corporation
• Susan Walshe, MFT, Inc
• Hayley Jones Sussman, PH.D.
• Pete Sutch
• Samantha Marie Sutfin, BSW, MSW, LCSW
• Tara Sutherland, M.D.
• Amy Michelle Sutton
• Bobbi Sutton, B.S.

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.