Collette Elke Supit, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D1001 Issued in GU

Practice address

415 Chalan San Antonio
Suite 108
Tamuning, GU 96913-3620

Phone

(671) 647-3526

NPI assigned

Mar 27, 2014

Last updated

Mar 27, 2014By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1427475300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 CALACHUCHA AVE",
            "city": "BARRIGADA",
            "state": "GU",
            "postal_code": "969131238",
            "telephone_number": "671-488-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CHALAN SAN ANTONIO",
            "address_2": "SUITE 108",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133620",
            "telephone_number": "671-647-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPIT",
        "first_name": "COLLETTE",
        "middle_name": "ELKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GU",
            "license": "D1001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hugh Sule, DDS
• John Sullivan, D.D.S.
• Kevin John Sullivan, CRNA
• Ariel Sumbo, RN
• Superdrug Tumon
• Edwin Jess Supit, M.D.
• Deborah Ann Swena, M.D.
• Sheri Lynne Tackett, APRN-CNP
• Patricia Leon Guerrero Taimanglo, PHD
• Denise Taitano-Ritter

• Dentist in Tamuning, GU
• Providers in Tamuning, GU by specialty
• Dentist in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.