Individual provider Active NPI

Kimberly Ann Saya Inouye, DMD

  • Periodontics
  • Ft Benning, GA
National Provider Identifier
1770567570
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DT-2166 Issued in HI
Practice address
7101 Hoff Street
USA Dentac
Ft Benning, GA 31905
Phone
(706) 544-4530
Fax
(706) 544-1933
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2166 HI
Periodontics 1223P0300X DT-2166 HI Primary

Addresses

Primary practice location

7101 Hoff Street
USA Dentac
Ft Benning, GA 31905

Mailing address

7101 Hoff Street
USA Dentac
Ft Benning, GA 31905
Phone (706) 544-4530

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
2166HIMDDentist
DT-2166HIMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1770567570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 HOFF STREET",
            "address_2": "USA DENTAC",
            "city": "FT BENNING",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "706-544-4530",
            "fax_number": "706-544-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 HOFF STREET",
            "address_2": "USA DENTAC",
            "city": "FT BENNING",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "706-544-4530",
            "fax_number": "706-544-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INOUYE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN SAYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "2166",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "HI",
            "license": "DT-2166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Benning, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.