Dominique Shaney Suber, RDHAP

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

HAP1092 Issued in CA

Practice address

3175 Puffin Cir
Fairfield, CA 94533-8914

Phone

(925) 421-8302

NPI assigned

Oct 14, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brighter Beginnings

  • Federally Qualified Health Center (FQHC)
  • Richmond, CA
  • NPI 1942638978
  Medicare reassignment NPD
• Charming Smiles Inc. Dental Hygiene,Practice of Dominique Suber,Rdhap

  • Dental Clinic/Center
  • Fairfield, CA
  • NPI 1740013226
  NPD Authorized official
• Brighter Beginnings

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1629275839
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1043030190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 PUFFIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945338914",
            "telephone_number": "925-421-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 PUFFIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945338914",
            "telephone_number": "925-421-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBER",
        "first_name": "DOMINIQUE",
        "middle_name": "SHANEY",
        "credential": "RDHAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "HAP1092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Grace Stutz, MFT
• Jonathan W Su, PTA
• Judy Su, D.D.S.
• Flor Suarez Plata
• Chanel Laraine Suarez
• Successful Pathways Behavioral Consulting Inc.
• Arpita Singh Sukhi
• Mark S Sullivan, M.D.
• Smita Dutta Suman
• Deborah J. Summers-Collins, R.N.

• Dental Hygienist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.