NPPES individual identifier and taxonomy
Matched to a register
As of September 27, 2026, CMS NPPES lists 1 active Type 1 individual provider NPI record(s) whose normalized personal name and full practice street, disclosed unit, city and state match this profile: 1558592022. Reported taxonomy codes: 122300000X.
The dated CMS NPPES V.2 bulk snapshot through September 27, 2026. A match requires an exact normalized individual provider name and exact full practice street, disclosed unit, city and state, an active Type 1 NPI, and a reported dental taxonomy. NPPES data are provider-reported; an NPI or taxonomy does not establish state licensure, credentialing, quality, insurance participation, or current operation.
Matched an individual (Type 1) NPI record to the directory person name after removing only common professional prefixes and credentials, then required the full normalized practice street and suite/unit to match, including an exact blank-unit match when neither record discloses a unit. The record must be active in the September monthly file and weekly updates through September 27, 2026, and report a dental taxonomy. NPIs repeated across separate profiles were excluded. CMS NPPES information is provider-reported and is not proof of licensure, credentialing, quality, insurance participation, or operation.
- CMS NPPES individual provider record 1558592022 · Source observed 2026-10-01
- CMS NPPES V.2 monthly and weekly downloadable files · Source observed 2026-10-01
Reviewed 2026-10-01 · Review due 2026-10-31 · Version 1