Provider Demographics
NPI:1164260360
Name:SUITE TOOTH PEDIATRICS
Entity type:Organization
Organization Name:SUITE TOOTH PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KATO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-860-4238
Mailing Address - Street 1:8324 MIDDLE RUDDINGS DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2781
Mailing Address - Country:US
Mailing Address - Phone:716-860-4238
Mailing Address - Fax:
Practice Address - Street 1:1229 GARRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-3655
Practice Address - Country:US
Practice Address - Phone:716-860-4238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental