Individual provider Active NPI

Troy Gombert, DDS

  • Dentist
  • Chandler, AZ
National Provider Identifier
1013006568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4908 Issued in AZ
Practice address
3800 W Ray Rd Ste 2
Chandler, AZ 85226-5940
Phone
(480) 899-2958
Fax
(480) 899-2968
NPI assigned
Oct 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4908 AZ Primary

Addresses

Primary practice location

3800 W Ray Rd Ste 2
Chandler, AZ 85226-5940

Mailing address

3800 W Ray Rd Ste 2
Chandler, AZ 85226-5940
Phone (480) 899-2958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150710002354 AZ Order and Referring Only - DentistPractitioner - Dentist 2668784182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4908AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013006568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-899-2958",
            "fax_number": "480-899-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-899-2958",
            "fax_number": "480-899-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMBERT",
        "first_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "4908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.