Raquel Alicia Green, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010739 Issued in AZ

Practice address

825 S Watson Rd Ste 101
Buckeye, AZ 85326-3435

Phone

(623) 386-7319

NPI assigned

Jul 1, 2020

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sundance Dental Group, LLP

  dba Sundance Dental Group

  • General Practice Dentistry
  • Buckeye, AZ
  • NPI 1487842423
  NPD

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1023635422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15390 W CENTERRA DR N APT 52",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384172",
            "telephone_number": "812-459-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S WATSON RD STE 101",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263435",
            "telephone_number": "623-386-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RAQUEL",
        "middle_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Health Medical, PLLC
• Good Health Medical, PLLC (My Dr Now)
• Michael P Goodrich
• Kendra Alanna Gort, PSY.D.
• Nancy Gray
• Joyce Faith Gross, LMSW
• Growing Edges LLC
• Sydney Guenther, FNP-C
• Jennifer Guess, PA-C
• Ricki Elizabeth Haab, PT, DPT

• General Practice Dentistry in Buckeye, AZ
• Providers in Buckeye, 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 Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.