Jason Edward Sudati, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

03648 Issued in NH

Practice address

316 S Main St
Manchester, NH 03102-4842

Phone

(603) 627-1301

NPI assigned

Jul 4, 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 29, 2016 through Mar 29, 2028

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.

• Urgent Dental Care of Somersworth, PLLC

  • Dental Clinic/Center
  • Somersworth, NH
  • NPI 1245703511
  NPD Authorized official

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1407886310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S MAIN ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031024842",
            "telephone_number": "603-627-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S MAIN ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031024842",
            "telephone_number": "603-627-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDATI",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21042",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "03648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Marie Stutzman, BA
• Melanie Marie Stys, BS
• Katherine Su, MD
• Nicole Sublette, LCMHC
• Sublime Transit LLC
• Daniel J Sullivan, RPH
• Gabrielle Sullivan, MSW
• Kayleigh Ann Sullivan, PA-C
• Lindsay Sullivan, RN
• Misha Sullivan, PA-C, ATC

• General Practice Dentistry in Manchester, NH
• Providers in Manchester, NH by specialty
• General Practice Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.