Provider Demographics
NPI:1942182563
Name:SUCKIEL, ENDIE NAIA (RDH)
Entity type:Individual
Prefix:
First Name:ENDIE
Middle Name:NAIA
Last Name:SUCKIEL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ENDIE
Other - Middle Name:NAIA
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:302 WIND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-4766
Mailing Address - Country:US
Mailing Address - Phone:443-500-8044
Mailing Address - Fax:
Practice Address - Street 1:14573 POTOMAC MILLS RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6808
Practice Address - Country:US
Practice Address - Phone:703-499-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402207678124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist