Active NPI
Scott Nakamura, DMD
- Periodontics
- Philadelphia, PA
National Provider Identifier
1982867412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS029571L
- Practice address
- 240 S 4TH St # 300
Philadelphia, PA 19106-3722 - Phone
- (215) 898-4615
- NPI assigned
- Jul 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS029571L | PA | Primary |
Addresses
Primary practice location
240 S 4TH St # 300
Philadelphia, PA 19106-3722
Mailing address
801 Rosehill Dr
King of Prussia, PA 19406-1787
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 |
|---|---|---|---|
| DS029571L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215043200000",
"number": "1982867412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 ROSEHILL DR",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194061787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 S 4TH ST # 300",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191063722",
"telephone_number": "215-898-4615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKAMURA",
"first_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-03",
"last_updated": "2008-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS029571L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.