Individual provider Active NPI

Suzanne Ierna, RDH

  • Dental Hygienist
  • Middletown, CT
National Provider Identifier
1720033558
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
004166 Issued in CT
Practice address
635 Main St
Middletown, CT 06457-2718
Phone
(860) 347-6971
Fax
(860) 638-6601
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 004166 CT Primary

Addresses

Primary practice location

635 Main St
Middletown, CT 06457-2718

Mailing address

635 Main St
Attn: Credentialing Department
Middletown, CT 06457-2718
Phone (860) 347-6971

Other names 1

  • Suzanne Sholly Former name

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

LicenseStateTypeSpecialty
004166CTMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720033558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MAIN ST",
            "address_2": "ATTN: CREDENTIALING DEPARTMENT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IERNA",
        "first_name": "SUZANNE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "004166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "SHOLLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.