DR. MARK A SUTOR (NPI# 1265565253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265565253 |
| Entity Type | Individual |
| Full Name | DR. MARK A SUTOR |
| Credential | DDS MSD |
| Practice Address |
379 S Park Ridge Rd Bloomington IN 47401-8574 |
| Practice Telephone | 8123334550 |
| Practice Fax Number | 8123335789 |
| Mailing Telephone | 8123334550 |
| Mailing Fax Number | 8123335789 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
12009269 | IN | Dental Providers |
| Street Address |
379 S PARK RIDGE RD |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47401-8574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740765791 | Holly G Carter | Physical Therapist | 3607 Heirloom Dr, Bloomington, IN 47401 | 2018-09-26 |
| 1285116657 | Kimberly D Bergan | Occupational Therapist | 3607 S Heirloom Dr, Bloomington, IN 47401 | 2018-09-03 |
| 1255836813 | Erin Kathleen Sain | Nurse Practitioner | 326 W Woodcrest Drive, Bloomington, IN 47401 | 2018-03-27 |
| 1881104289 | Ev Bloomington Limited Partnership | Assisted Living Facility | 3607 South Heirloom Drive, Bloomington, IN 47401 | 2017-10-11 |
| 1619496536 | Kirsten N Neely | Physical Therapist | 2604 E. Creek's Edge Dr., Bloomington, IN 47401 | 2017-09-12 |
| 1023533908 | Hoosier United Therapy Service LLC | Physical Therapist | 2801 E Plateau Place, Bloomington, IN 47401 | 2017-08-11 |
| 1194127381 | Ann Marie Neeley | Lactation Consultant, Non-RN | 2458 South Walnut Street, Bloomington, IN 47401 | 2014-09-19 |
| 1518397801 | Indiana Spine and Sports Inc. | Chiropractor | 418 S Walnut St Suite C, Bloomington, IN 47401 | 2013-11-22 |
| 1053654574 | William Robblee Anderson | Obstetrics & Gynecology | 2625 E. Spicewood Ct., Bloomington, IN 47401 | 2013-04-03 |
| 1285979377 | Jenna Marie Dale | Optometrist | 322 S. Woodcrest Drive Precision Eye Group, Bloomington, IN 47401 | 2012-11-30 |
| Find all providers in zip 47401 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912036708 | Thomas Merle Johnson | Dentist | 2103 E Washington St Ste 4a, Bloomington, IL 61701-4365 | 2007-03-05 |
| 1730205121 | William John Sentiere | Dentist | 3925 Hagan St, 204, Bloomington, IN 47401-8556 | 2007-03-21 |
| 1730243056 | Kenneth Gerstein | Dentist | 1404 Eastland Dr, Bloomington, IL 61701-3532 | 2006-12-21 |
| 1366539744 | Anthony Pecora Pecora | Dentist | 2103 E Washington St, Bloomington, IL 61701-4310 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114524477 | Katherine E. Ferry | Dentist | 4303 E Windsor Ln, Columbus, IN 47201-4022 | 2020-10-08 |
| 1609421965 | Hawra Alqallaf | Dentist | 1121 W Michigan St # Ds422, Indianapolis, IN 46202-5211 | 2019-08-05 |
| 1952814238 | Center for Implant Denistry and Periodontics, LLC | Dentist | 9885 E 116th St Ste 300, Fishers, IN 46037-9242 | 2017-11-09 |
| 1518470897 | Meridian Street Periodontics, LLC | Dentist | 8801 N Meridian St Ste 103, Indianapolis, IN 46260-2353 | 2017-11-09 |
| 1538410451 | Eon Clinics Indiana LLC | Dentist | 10020 Calumet Ave, Munster, IN 46321-4055 | 2012-10-02 |
| 1164726832 | Indy East Periodontics PC | Dentist | 115 N Shortridge Rd Ste 100, Indianapolis, IN 46219-4917 | 2011-01-10 |
| 1588997183 | Shane T Cope Dds, PC | Dentist | 10435 Commerce Drive, Suite 120, Carmel, IN 46032 | 2009-09-14 |
| 1366697070 | Bruce B. Wiland, Dds, Msd | Dentist | 3415 S Lafountain St Ste K, Kokomo, IN 46902-3827 | 2008-11-21 |
| 1023267770 | James M. Humphrey | Dentist | 221 S. 19th Street, Terre Haute, IN 47807-4129 | 2008-09-17 |
| 1891968194 | James Kirk | Dentist | 500 W Lincoln Hwy Ste N, Merrillville, IN 46410 | 2008-04-08 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.