Suncoast Oral Surgery & Periodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUNCOAST ORAL SURGERY & PERIODONTICS

Practice address

200 Tamiami TRL N
Venice, FL 34285-1914

Phone

(941) 484-4001

NPI assigned

Jul 6, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDALLION PERIODONTICSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary Clements

Title

Practice Manager

Phone

(863) 832-0028

Specialties & licenses 3

Addresses

Part of

Suncoast Oral Surgery Periodontics

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700307220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TAMIAMI TRL N",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342851914",
            "telephone_number": "941-484-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TAMIAMI TRL N",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342851914",
            "telephone_number": "941-484-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Tamiami Trl N",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342851914",
            "country_code": "US",
            "telephone_number": "941-484-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNCOAST ORAL SURGERY & PERIODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDALLION PERIODONTICS",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "863-832-0028",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Suggs
• Charles A Suleskey, DPM
• Summerville at Venice, LLC (Emeritus at Venice)
• Sun Medical Supply, Inc.
• Suncoast Eyehealth P.a.
• Suncoast Orthopaedic Surgery & Sports Medicine, P.a.
• Suncoast Orthotics and Prosthetics, Inc.
• Suncoast Pathology
• Suncoast Pelvic Therapy & Wellness, PLLC
• Suncoast Trim Clinic, LLC

• Dental Clinic/Center in Venice, FL
• Providers in Venice, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.