Conchita O Mercado, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5913 Issued in AZ

Practice address

1101 Riata Valley Rd
Kingman, AZ 86409

Phone

(928) 692-9394

Fax

(928) 692-9399

NPI assigned

May 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1013118306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 RIATA VALLEY RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-692-9394",
            "fax_number": "938-692-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 RIATA VALLEY RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-692-9394",
            "fax_number": "928-692-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "CONCHITA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorena Ruth Meier, R.D.
• Stacey Lee Meier, FNP-C
• Clark E Melstrom
• Xochitl A. Mendez, D.O.
• Mentally Ill Kids in Distress
• Michael G Valpiani MD Az LTD
• Michael Stagner,M.D. P.C
• Evan James Michelson
• Jack Glenn Miller, CTN
• Marc L Miller, MD

• General Practice Dentistry in Kingman, AZ
• Providers in Kingman, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.