Bruce Shintaro Abe, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

47344 Issued in CA

Practice address

501 Washington St Ste 740
San Diego, CA 92103-2231

Phone

(619) 393-7511

NPI assigned

Feb 21, 2006

Last updated

Sep 25, 2023By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Jon E Peterson D.D.S. , Apc

  • Periodontics
  • San Diego, CA
  • NPI 1386736445
  NPD (past)
• Peterson and Abe

  • Periodontics
  • San Diego, CA
  • NPI 1942604277
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1235104688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST STE 740",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-417-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST STE 740",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-393-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABE",
        "first_name": "BRUCE",
        "middle_name": "SHINTARO",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "47344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Razyya L Abdulmumin, B.A.
• Shatha Abdulrazak
• Tijani Bamidele Abdulsalam, IDC
• Zohal Abdurahman, RN
• Najah Abdus-Salaam
• Katsue Abe, MT
• Tigist Bule Abe
• Hamid Abedi, HEARING AID SPECIALI
• Whigmass D Abegaz, ASCP
• Kristy Elizabeth Abel

• Periodontics in San Diego, CA
• Providers in San Diego, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.