Individual provider Active NPI

Scott Miles Parker, D.D.S.

  • Dentist
  • Tamuning, GU
National Provider Identifier
1649415464
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-1012 Issued in GU
Practice address
388 Ypao Rd
Tamuning, GU 96913-3701
Phone
(671) 646-8881
Fax
(671) 648-2556
NPI assigned
Dec 8, 2008
Last updated
Dec 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-1012 GU Primary

Addresses

Primary practice location

388 Ypao Rd
Tamuning, GU 96913-3701

Mailing address

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

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
D-1012GUMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1649415464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-648-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-648-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SCOTT",
        "middle_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GU",
            "license": "D-1012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.