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Dr. Ian Thor Sutherland , DDS

Dentist β€’ Jbsa Lackland, TX

Active NPI 1558928655 Individual Practitioner Male Practitioner
Practice location in NPPES

2133 Pepperrell St
Jbsa Lackland, TX 782365313

Call 3303546250 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2133 Pepperrell St

Jbsa Lackland, TX 782365313

Telephone 3303546250
Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Malmstrom Afb, MT; Wright Pat, OH. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Jbsa Lackland and Texas

44 active clinicians are listed under Dentist with a practice address in Jbsa Lackland, TX (6,580 in Texas).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Jbsa Lackland

0% of these 44 clinicians have the CMS telehealth indicator.

0% of these 44 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-11
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES MT DEN-DEN-LIC-19483

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Secondary Practice Locations

4881 Sugar Maple Dr

Wright Pat, OH 454335529

Phone: 9372570837

7300 N Perimeter Rd

Malmstrom Afb, MT 594026701

Phone: 4067312528

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Song Rhim , DMD

Dentist - Periodontics

NPI 1336369750

Doctor of Dental Medicine

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ“
Updated Practice Location August 11, 2023

Registered at 2133 PEPPERRELL ST, JBSA LACKLAND, TX 782365313 (Tel: 3303546250)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2023

Student in an Organized Health Care Education/Training Program

πŸ“
Updated Practice Location December 10, 2020

Registered at 7300 N PERIMETER RD, MALMSTROM AFB, MT 594026701 (Tel: 4067312528)

πŸ“
Updated Business Mailing Address December 10, 2020

Registered at 3625 9TH AVE S, GREAT FALLS, MT 594053433 (Tel: 3303546250)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2020

Dentist (license number reported to NPPES: MT DEN-DEN-LIC-19483)

βœ…
NPI Profile Active May 23, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 23, 2019

Registered at 4881 SUGAR MAPLE DR, WRIGHT PAT, OH 454335529 (Tel: 9372570837)

πŸ“
Business Mailing Address (Initial Record) May 23, 2019

Registered at 4464 STONEGATE DR APT G, BEAVERCREEK, OH 454306602 (Tel: 3303546250)

πŸ‘€
Provider Name / Credentials (Initial Record) May 23, 2019

Recorded as IAN SUTHERLAND, DDS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2019

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration May 23, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1558928655
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 23, 2019
Last Update: August 11, 2023
Sole Proprietor: Yes

Other Dentists in Jbsa Lackland

Mailing Address

3625 9th Ave S

Great Falls, MT 594053433

Phone: 3303546250

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.