Active NPI
Darron R Mortenson, DMD, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Tan Valley, AZ
National Provider Identifier
1023041282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 5972
- Practice address
- 2510 E Hunt Hwy
#29
San Tan Valley, AZ 85143-5206 - Phone
- (480) 457-1623
- Fax
- (480) 457-1321
- NPI assigned
- Jul 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 5972 | AZ | Primary |
Addresses
Primary practice location
2510 E Hunt Hwy
#29
San Tan Valley, AZ 85143-5206
Mailing address
2510 E Hunt Hwy
#29
San Tan Valley, AZ 85143-5206
Phone (480) 457-1623
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5972 | AZ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1023041282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 E HUNT HWY",
"address_2": "#29",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435206",
"telephone_number": "480-457-1623",
"fax_number": "480-457-1321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 E HUNT HWY",
"address_2": "#29",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435206",
"telephone_number": "480-457-1623",
"fax_number": "480-457-1321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSON",
"first_name": "DARRON",
"middle_name": "R",
"credential": "DMD, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-09",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "AZ",
"license": "5972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Tan Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.