Bryan Suydam, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039902 Issued in PA

Practice address

1099 Ohio River Blvd
Sewickley, PA 15143-2056

Phone

(412) 741-1234

Fax

(412) 741-1585

NPI assigned

May 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1902073752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 OHIO RIVER BLVD",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151432056",
            "telephone_number": "412-741-1234",
            "fax_number": "412-741-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 OHIO RIVER BLVD",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151432056",
            "telephone_number": "412-741-1234",
            "fax_number": "412-741-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUYDAM",
        "first_name": "BRYAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039902",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-2368",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheri Ann Sturm, OD
• Suburban Imaging Associates, PC
• Stephanie Lee Suhayda
• Vicki Lynn Surgenavic, CRNP
• Surgical Associates of Sewickley
• Fiona Georgiana Suydam, M.D.
• Beth Fausnaught Sweeting, LPCC
• Shelby Elizabeth Sydenstricker, AUD
• John Joseph Szczypinski II, DPT
• Emily Szymanski

• General Practice Dentistry in Sewickley, PA
• Providers in Sewickley, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.