Sudan Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

60267 Issued in CA

Legal business name

SUDAN DENTAL CORPORATION

Doing business as

Chino Dental Arts

Practice address

4110 Edison Ave
107-B
Chino, CA 91710-8409

Phone

(909) 536-1900

NPI assigned

Dec 7, 2016

Last updated

Dec 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anisha Sudan, DDS

Title

Owner

Phone

(909) 536-1900

Specialties & licenses 1

Addresses

Other names 1

• Chino Dental Arts Doing business as

Locations

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1912441148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 EDISON AVE",
            "address_2": "107-B",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917108409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 EDISON AVE",
            "address_2": "107-B",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917108409",
            "telephone_number": "909-536-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "SUDAN",
        "authorized_official_first_name": "ANISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-536-1900",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chino Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darren L. Stewart, D.C.
• Marie Alexia Stoddard Lyndsey, MD
• Jewwhei Su
• Xuantong Su
• Cynthia Suarez, BA
• Justin Suh
• Jasmin Sullivan, PSYD
• Marguerite Gozun Sumadchat, PT
• Isabelle Sun
• Suncrest Cca

• Dentist in Chino, CA
• Providers in Chino, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.