Individual provider Active NPI

Nobiru Suzuki, DMD

  • Dentist
  • Gloucester, MA
National Provider Identifier
1235622937
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857928 Issued in MA
Practice address
123 Main St Ste 2D
Gloucester, MA 01930-5766
Phone
(978) 865-3360
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857928 MA Primary

Addresses

Primary practice location

123 Main St Ste 2D
Gloucester, MA 01930-5766

Mailing address

700 Harrison Ave Unit 410
Boston, MA 02118-2740

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

LicenseStateTypeSpecialty
DN1857928MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1235622937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HARRISON AVE UNIT 410",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MAIN ST STE 2D",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019305766",
            "telephone_number": "978-865-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUZUKI",
        "first_name": "NOBIRU",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.