Harlyn Kaur Susarla, DMD, MPH

Primary specialty

DentistTaxonomy code 122300000X

License

DE60654328 Issued in WA

Practice address

111 SE Everett Mall Way
Everett, WA 98208-3208

Phone

(425) 212-1810

NPI assigned

Apr 23, 2014

Last updated

Aug 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Harlyn Kaur Sidhu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: hsusarla88495@direct.seattlechildrens.org

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1801216270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SE EVERETT MALL WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083208",
            "telephone_number": "425-212-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SE EVERETT MALL WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083208",
            "telephone_number": "425-212-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSARLA",
        "first_name": "HARLYN",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15669",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60654328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HARLYN",
            "last_name": "SIDHU",
            "middle_name": "KAUR",
            "credential": "MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Everett, WA
• Providers in Everett, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.