Dr. Jonathan C Sudol
Oral and Maxillofacial Surgeon
75 Van Deene Ave Suite 201
West Springfield
, Massachusetts 01089-3258
Dr. Jonathan C Sudol
Oral and Maxillofacial Surgeon
75 Van Deene Ave Suite 201
West Springfield
, Massachusetts 01089-3258
(413) 788-9621
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Jonathan C Sudol
- 75 Van Deene Ave Suite 201
- West Springfield, MA
- Zip : 01089-3258
- Phone : (413) 788-9621
Second Address
- Dr. Jonathan C Sudol
- 75 Van Deene Ave Suite 201
- West Springfield, MA
- Zip : 01089-3258
- Phone : (413) 788-9621
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Is Dr. Jonathan C Sudol a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 20461 | MA |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | 3265 | NH |
National Provider Identifier
| NPI | 1033222583 |
|---|---|
| Provider Name | Dr. Jonathan C Sudol |
| First Address | West Springfield, MA 01089-3258 |
| Second Address | West Springfield, MA 01089-3258 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2006 |
| Last Update Date | 06/03/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U90013 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.