Provider Demographics
NPI:1447735949
Name:HOTHI, SUMAN (DMD)
Entity type:Individual
Prefix:
First Name:SUMAN
Middle Name:
Last Name:HOTHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10216 SE 256TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6437
Mailing Address - Country:US
Mailing Address - Phone:253-856-3384
Mailing Address - Fax:
Practice Address - Street 1:10216 SE 256TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6437
Practice Address - Country:US
Practice Address - Phone:253-856-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60865245122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist