Individual provider Active NPI

Thomas R Sumnicht, D.D.S.

  • General Practice Dentistry
  • Chula Vista, CA
National Provider Identifier
1740380716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34228 Issued in CA
Practice address
11 Naples St
Chula Vista, CA 91911-2205
Phone
(619) 426-5640
Fax
(619) 426-1763
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34228 CA Primary

Addresses

Primary practice location

11 Naples St
Chula Vista, CA 91911-2205

Mailing address

3875 Alta Loma CT
Jamul, CA 91935-1704
Phone (619) 444-5816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160607000716 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911297775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740380716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 ALTA LOMA CT",
            "city": "JAMUL",
            "state": "CA",
            "postal_code": "919351704",
            "telephone_number": "619-444-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NAPLES ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112205",
            "telephone_number": "619-426-5640",
            "fax_number": "619-426-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNICHT",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.