Active NPI
Serena Ide Noumy
- Dentist
- Mesa, AZ
National Provider Identifier
1104277599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- B62417903
- Practice address
- 5850 E Still Cir
Mesa, AZ 85206-3618 - Phone
- (480) 265-8005
- NPI assigned
- Jun 27, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | B62417903 | VA | Primary |
Addresses
Primary practice location
5850 E Still Cir
Mesa, AZ 85206-3618
Mailing address
8275 E Bell Rd Apt 3205
Scottsdale, AZ 85260-1039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B62417903 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1104277599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8275 E BELL RD APT 3205",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852601039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5850 E STILL CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852063618",
"telephone_number": "480-265-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDE NOUMY",
"first_name": "SERENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "B62417903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.