Active NPI
Susan Shim, DDS
- Dentist
- Kailua, HI
National Provider Identifier
1730434481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2480
- Practice address
- 970 N Kalaheo Ave
Suite A305
Kailua, HI 96734-1866 - Phone
- (808) 254-5454
- NPI assigned
- Jul 18, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2480 | HI | Primary |
Addresses
Primary practice location
970 N Kalaheo Ave
Suite A305
Kailua, HI 96734-1866
Mailing address
970 N Kalaheo Ave
Suite A305
Kailua, HI 96734-1866
Phone (808) 254-5454
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marcus a Hannah DDS LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1730434481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 N KALAHEO AVE",
"address_2": "SUITE A305",
"city": "KAILUA",
"state": "HI",
"postal_code": "967341866",
"telephone_number": "808-254-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 N KALAHEO AVE",
"address_2": "SUITE A305",
"city": "KAILUA",
"state": "HI",
"postal_code": "967341866",
"telephone_number": "808-254-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIM",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-18",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "HI",
"license": "2480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.