Provider Demographics
NPI:1487213955
Name:SUTHERLAND, HANNAH (DDS)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4464 STONEGATE DR APT G
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-6602
Mailing Address - Country:US
Mailing Address - Phone:941-773-1561
Mailing Address - Fax:
Practice Address - Street 1:9703 BANDERA RD STE 210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-5622
Practice Address - Country:US
Practice Address - Phone:210-864-0086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist