Rafael Angel Suarez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10846 Issued in KY

Practice address

9219 US Highway 42 Ste a
Prospect, KY 40059-8875

Phone

(502) 228-2709

NPI assigned

Sep 26, 2022

Sex

Male

Sole proprietor

No

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

Enrolled in KY

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1609590462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8417 AMBROSSE LN UNIT 104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402997367",
            "telephone_number": "502-210-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9219 US HIGHWAY 42 STE A",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598875",
            "telephone_number": "502-228-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "RAFAEL",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Lavelle Staffieri, DMD
• Tammy C Stebbins, M.S., SLP
• Stephanie M. Russell MD PSC
• Laura Elaine Stone, P.T.
• Nicole B Strecker, M.D.
• Melanie Kim Summers, LPCC
• Tamella Buss Cassis MD PLLC
• Taylor Services
• Bailee Taylor
• Brigid Shea Taylor

• General Practice Dentistry in Prospect, KY
• Providers in Prospect, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.