Dennis Su, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55688 Issued in CA

Practice address

572 Pleasant St
Malden, MA 02148

Phone

(781) 397-8876

Fax

(781) 324-7166

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boston Family Dental LLC

  • General Practice Dentistry
  • Malden, MA
  • NPI 1801962618
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1184709487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MARIN PRIVADO",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91764",
            "telephone_number": "909-896-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 PLEASANT ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "02148",
            "telephone_number": "781-397-8876",
            "fax_number": "781-324-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21440",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard D Stranger, D.C.
• Allison Linnea Stroh
• Jessica Michael Irihapeti Stubbing, D. CLIN PSYCH
• Caroline Stubbs
• Emma Stump
• Subhash C Bowry MD PC
• James Patrick Sullivan, MD
• Laura J Sullivan, MD
• Thomas S Sullivan, DC
• Timothy Sullivan, LICSW

• General Practice Dentistry in Malden, MA
• Providers in Malden, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.