Mary Suzanne Ahnquist, D.M.D.
Individual provider Active NPI Dentist · Drexel Hill, PA
NPI 1679640312 · NPPES record last updated May 12, 2015
Key facts
- NPI
- 1679640312
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS039280 (PA)
- Practice address
- 1225 Cornell Ave
Drexel Hill, PA 19026-3219 - Phone
- (859) 333-8757
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 2, 2017 through Nov 2, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6029 | KY | MD | Dentist |
| DS039280 | PA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6029 | KY | |
| Dentist | 122300000X | DS039280 | PA | Yes |
Addresses
Primary practice location
1225 Cornell Ave
Drexel Hill, PA 19026-3219
Mailing address
1225 Cornell Ave
Drexel Hill, PA 19026-3219
Phone (859) 333-8757
Other names
- Dr. M. Suzanne Ahnquist
Other providers in Drexel Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.