Allan C Sundin DDS Ms PC

Primary specialty

DentistTaxonomy code 122300000X

License

111973R Issued in VA

Legal business name

ALLAN C SUNDIN DDS MS PC

Practice address

2107 Hartford Rd
Hampton, VA 23666-2407

Phone

(757) 838-0800

Fax

(757) 827-8532

NPI assigned

Nov 28, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Shirley A Smith

Title

Office Manager

Phone

(757) 425-1547

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669455358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 HARTFORD RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662407",
            "telephone_number": "757-838-0800",
            "fax_number": "757-827-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 HARTFORD RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662407",
            "telephone_number": "757-838-0800",
            "fax_number": "757-827-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLAN C SUNDIN DDS MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-425-1547",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "111973R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.