Individual provider Active NPI

Amy Marie Nordquist, D.D.S.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1023365764
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D008427 Issued in AZ
Practice address
15215 S 48TH St Ste 190
Phoenix, AZ 85044-9140
Phone
(480) 706-0029
NPI assigned
Aug 13, 2012
Last updated
Oct 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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 D008427 AZ Primary

Addresses

Primary practice location

15215 S 48TH St Ste 190
Phoenix, AZ 85044-9140

Mailing address

1202 E Zion Way
Chandler, AZ 85249-5191
Phone (480) 706-0029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150820010881 CA Order and Referring Only - DentistPractitioner - Dentist 7810202736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffery a Kohler, DDS, PC PastSince Oct 19, 2020 Accepting new patients
Las Tiendas Dental Group, LLP General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1023365764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E ZION WAY",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495191",
            "telephone_number": "480-706-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST STE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449140",
            "telephone_number": "480-706-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDQUIST",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.