Stephanie Liane Sue, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS105961 Issued in CA

Practice address

2277 Michael Dr Ste 2
Newbury Park, CA 91320-3263

Phone

(805) 498-2802

NPI assigned

Mar 18, 2019

Sex

Female

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

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1386103521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 MICHAEL DR STE 2",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913203263",
            "telephone_number": "805-728-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 MICHAEL DR STE 2",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913203263",
            "telephone_number": "805-498-2802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUE",
        "first_name": "STEPHANIE",
        "middle_name": "LIANE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS105961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Stoops, PH.D.
• Paul D Streck Jr., D.M.D., M.D.
• Sondra Stubblefield, LCSW
• Weiyang Stanley Su, M.D.
• Karen Sue, DDS
• Brian J Supple, M.D.
• Supplemental Health Care
• Alicia Ann Swan, M.P.T.
• Kennidy P Taylor, MS, RDN
• Erinn Courteney Tempelis, PA-C

• Pediatric Dentistry in Newbury Park, CA
• Providers in Newbury Park, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.