Individual provider Active NPI

Udechukwu Iheduru, DMD

  • General Practice Dentistry
  • Apache Junction, AZ
National Provider Identifier
1003586785
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011871 Issued in AZ
Practice address
110 S Idaho Rd Ste 260
Apache Junction, AZ 85119-2379
Phone
(480) 982-0782
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 D011871 AZ Primary

Addresses

Primary practice location

110 S Idaho Rd Ste 260
Apache Junction, AZ 85119-2379

Mailing address

2065 E Saddlebrook CT
Gilbert, AZ 85298-7416
Phone (602) 750-1300

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
D011871AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson.Ferguson,Steinhart. James.PLLC PastSince Sep 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1003586785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 E SADDLEBROOK CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852987416",
            "telephone_number": "602-750-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S IDAHO RD STE 260",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851192379",
            "telephone_number": "480-982-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEDURU",
        "first_name": "UDECHUKWU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.