Active NPI
Susan H Sheets, D.D.S.
- Pediatric Dentistry
- Cape Girardeau, MO
National Provider Identifier
1598868457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 13360
- Practice address
- 2436 Myra Drive
Cape Girardeau, MO 63703 - Phone
- (573) 334-9334
- Fax
- (573) 334-2780
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 13360 | MO | Primary |
Addresses
Primary practice location
2436 Myra Drive
Cape Girardeau, MO 63703
Mailing address
2436 Myra Drive
Cape Girardeau, MO 63703
Phone (573) 334-9334
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 831799 | Other | MO | UNITED CONCORDIA INS ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13360 | MO | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1598868457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2436 MYRA DRIVE",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "63703",
"telephone_number": "573-334-9334",
"fax_number": "573-334-2780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2436 MYRA DRIVE",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "63703",
"telephone_number": "573-334-9334",
"fax_number": "573-334-2780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEETS",
"first_name": "SUSAN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MO",
"license": "13360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INS ID",
"identifier": "831799",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.