Tiffany L Sum, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105035 Issued in CA

Practice address

1411 E 31St St BLDG E2
Oakland, CA 94602-1092

Phone

(510) 437-4101

NPI assigned

May 14, 2020

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsum13396@alamedahs.direct-ci.com

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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment NPD
• Alameda Health System

  • Clinic/Center
  • Alameda, CA
  • NPI 1124446158
  NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1346862166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ELLINGTON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941123623",
            "telephone_number": "415-683-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST BLDG E2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUM",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Sullivan, M.S.CLINICALREHABSE
• Mark Sullivan, PH.D., MFT
• Mollie Frances Sullivan, LM, CPM
• Sarah Sullivan, NURSE PRACTITIONER
• Sandra Lynn Sulprizio, MSPA
• Aron Sumii, MFT
• Lisa Bonta Sumii, LCSW
• Danielle Sumler
• Rajanna Lucruita Sumler
• Suzanne H. Summer, MD

• Dentist in Oakland, CA
• Providers in Oakland, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.