1. Home
  2. Directory
  3. Arizona
  4. Mesa
  5. Dentist
  6. NPI Profile

COUNTRY CLUB SMILES
NPI 1811227002
Dentist - General Practice in Mesa, AZ

Active since January 11, 2010
500 W SOUTHERN AVE, SUITE 100, MESA, AZ 85210(480) 962-0900(480) 833-3336 Get Directions Write a Review

NPPES record last updated: January 11, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Country Club Smiles NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY CLUB SMILES (NPI 1811227002) is a healthcare organization registered as a general practice in Mesa, Arizona and active in the NPI registry since January 2010. The organization lists Kimberly A. Mack, Owner, as its authorized official.

NPPES Registry Identity

NPI1811227002
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSUEKKO MANAGEMENT
Location Address500 W SOUTHERN AVE, SUITE 100Mesa, AZ 85210-5016
Mailing Address500 W Southern Ave, Suite 100Mesa, AZ 85210-5016 · (480) 962-0900 · Fax (480) 833-3336
Phone(480) 962-0900
Fax(480) 833-3336
Organization SubpartNo
Authorized OfficialKimberly A. MackOwner · (480) 231-7020
Enumeration DateJanuary 11, 2010
✔ NPI 1811227002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
500 W SOUTHERN AVE, Mesa, AZ 85210
Open in Google Maps ↗

Other Names 1

Doing Business AsCountry Club Smiles

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANTAL DENTAL CORPORATION
Advanced Practice Dental Therapist
500 W SOUTHERN AVE, #1-3
MESA, AZ 85210
Maricopa County (480) 664-1449
DR. KARL BAKER DDS
Dentist (General Practice)
500 W SOUTHERN AVE, SUITE 1
MESA, AZ 85210
Maricopa County (480) 962-0900
DR. DAN MOSHE GAFNI D.M.D
Dentist
500 W SOUTHERN AVE, #1
MESA, AZ 85210
Maricopa County (480) 664-1449

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Suekko Management's NPI number?

The NPI number for Suekko Management is 1811227002. It was assigned to this organization in the NPPES registry on January 11, 2010. The provider is doing business as Country Club Smiles.

Where is Suekko Management located?

Suekko Management is located at 500 W Southern Ave Suite 100, Mesa, AZ 85210. The listed phone number is (480) 962-0900.

What is Suekko Management's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Suekko Management was last updated on January 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.