Suzanne U McCormick, MS, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

50704 Issued in CA

Practice address

355 Santa Fe Dr
Suite100
Encinitas, CA 92024-5132

Phone

(760) 753-5300

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Surgical Institute

  • Ambulatory Surgical Clinic/Center
  • Encinitas, CA
  • NPI 1184870909
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962554428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 SANTA FE DR",
            "address_2": "SUITE100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245132",
            "telephone_number": "760-753-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 SANTA FE DR",
            "address_2": "SUITE100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245132",
            "telephone_number": "760-753-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "SUZANNE",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "MS, DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50704",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "042762",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "2867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Alice McCarthy, D.C.
• Lauren McCaughan
• Lynn McComas, MSN, ANP-C
• Melissa Marlene McCool, L.C.S.W.
• McCormack Dental Imaging
• Rodney Warren McCoubrey, HHP
• Alexis McCoy
• Elizabeth K McDaniel, DACM, L.AC.
• Lorraine Bagaan McDaniel, OTR/L
• Harrison R McDonald, MD

• Oral and Maxillofacial Surgery (Dentist) in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.