Su-En Chu Thlick, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401008779 Issued in VA

Practice address

12701 Marblestone Dr Ste 260
Woodbridge, VA 22192-8326

Phone

(703) 670-2114

Fax

(703) 423-0130

NPI assigned

Dec 27, 2005

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

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.

• Su-En C Thlick, DMD

  • General Practice Dentistry
  • Woodbridge, VA
  • NPI 1023207792
  NPD (past) Authorized official

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1255318754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 MARBLESTONE DR STE 260",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928326",
            "telephone_number": "703-670-2114",
            "fax_number": "703-423-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 MARBLESTONE DR STE 260",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928326",
            "telephone_number": "703-670-2114",
            "fax_number": "703-423-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THLICK",
        "first_name": "SU-EN",
        "middle_name": "CHU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.