Active NPI
Linda R Suralie, DDS
- Periodontics
- Phila, PA
National Provider Identifier
1629292529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS029075-L
- Practice address
- 7156 Stenton Ave
Phila, PA 19150-3428 - Phone
- (215) 242-3397
- Fax
- (215) 242-1171
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS029075-L | PA | Primary |
Addresses
Primary practice location
7156 Stenton Ave
Phila, PA 19150-3428
Mailing address
7715 Crittenden St
#336
Phila, PA 19118-4421
Phone (215) 242-3397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS029075-L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629292529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7715 CRITTENDEN ST",
"address_2": "#336",
"city": "PHILA",
"state": "PA",
"postal_code": "191184421",
"telephone_number": "215-242-3397",
"fax_number": "215-242-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7156 STENTON AVE",
"city": "PHILA",
"state": "PA",
"postal_code": "191503428",
"telephone_number": "215-242-3397",
"fax_number": "215-242-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURALIE",
"first_name": "LINDA",
"middle_name": "R",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS029075-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.