Suekko Management

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SUEKKO MANAGEMENT

Doing business as

Country Club Smiles

Practice address

500 W Southern Ave
Suite 100
Mesa, AZ 85210-5016

Phone

(480) 962-0900

Fax

(480) 833-3336

NPI assigned

Jan 11, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly A. Mack, RDH

Title

Owner

Phone

(480) 231-7020

Specialties & licenses 1

Addresses

Other names 1

• Country Club Smiles Doing business as

Locations

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1811227002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SOUTHERN AVE",
            "address_2": "SUITE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105016",
            "telephone_number": "480-962-0900",
            "fax_number": "480-833-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SOUTHERN AVE",
            "address_2": "SUITE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105016",
            "telephone_number": "480-962-0900",
            "fax_number": "480-833-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUEKKO MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-231-7020",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Club Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Loreta Suarez
• Monica Suarez, COTA
• Priti Sud, MD
• Margaret Sudimack
• Eric Suedmeyer, PHD
• G Andrew Sulit, MD
• Rachel Sullivan, FNP
• Shawn E Sullivan, MD
• Shea Sullivan, PHYSICIAN ASSISTANT
• Tessa Sullivan

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.