Active NPI
Somonkul Alexander Tum, D.M.D.
- Dentist
- Minerva, OH
National Provider Identifier
1639501117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30024638
- Practice address
- 817 E Lincolnway
Minerva, OH 44657-1211 - Phone
- (330) 868-5001
- NPI assigned
- Aug 6, 2013
- Last updated
- Feb 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 63792 | CA | |
| Dentist | 122300000X | 30024638 | OH | Primary |
Addresses
Primary practice location
817 E Lincolnway
Minerva, OH 44657-1211
Mailing address
817 E Lincolnway
Minerva, OH 44657-1211
Phone (330) 868-5001
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30024638 | OH | MD | Dentist |
| 63792 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454889600000",
"number": "1639501117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 E LINCOLNWAY",
"city": "MINERVA",
"state": "OH",
"postal_code": "446571211",
"telephone_number": "330-868-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 E LINCOLNWAY",
"city": "MINERVA",
"state": "OH",
"postal_code": "446571211",
"telephone_number": "330-868-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUM",
"first_name": "SOMONKUL",
"middle_name": "ALEXANDER",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-06",
"last_updated": "2016-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63792",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30024638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minerva, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.