Active NPI
Peter T Su, D.D.S.
- General Practice Dentistry
- San Francisco, CA
National Provider Identifier
1972638856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 44782
- Practice address
- 1914 Ocean Ave
San Francisco, CA 94127-2744 - Phone
- (415) 333-8200
- Fax
- (415) 333-8456
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 44782 | CA | Primary |
Addresses
Primary practice location
1914 Ocean Ave
San Francisco, CA 94127-2744
Mailing address
1914 Ocean Ave
San Francisco, CA 94127-2744
Phone (415) 333-8200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44782 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972638856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1914 OCEAN AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941272744",
"telephone_number": "415-333-8200",
"fax_number": "415-333-8456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1914 OCEAN AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941272744",
"telephone_number": "415-333-8200",
"fax_number": "415-333-8456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "PETER",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "44782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.