Individual provider Active NPI

Andrew Watson Himm, D.D.S.

  • Dentist
  • San Diego, CA
National Provider Identifier
1588858641
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019687 Issued in MI
Practice address
4862 Santa Cruz Ave
San Diego, CA 92107-3309
Phone
(248) 982-1189
NPI assigned
Aug 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019687 MI Primary

Addresses

Primary practice location

4862 Santa Cruz Ave
San Diego, CA 92107-3309

Mailing address

4862 Santa Cruz Ave
San Diego, CA 92107-3309
Phone (248) 982-1189

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
2901019687MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1588858641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4862 SANTA CRUZ AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073309",
            "telephone_number": "248-982-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4862 SANTA CRUZ AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073309",
            "telephone_number": "248-982-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMM",
        "first_name": "ANDREW",
        "middle_name": "WATSON",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.