Justin Dutton, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D5385 Issued in AZ

Practice address

15920 S Rancho Sahuarita Blvd
Suite One Hundred
Sahuarita, AZ 85629-8012

Phone

(520) 838-0600

Fax

(520) 838-0865

NPI assigned

Mar 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

State licenses

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 and National Provider Directory roles.

• Coppermine Dental Studio at Madera Canyon PLLC

  • Dentist
  • Green Valley, AZ
  • NPI 1811479074
  NPD Authorized official
• Coppermine Dental Studio at Rancho Sahuarita PLLC

  • Dentist
  • Sahuarita, AZ
  • NPI 1376025536
  NPD Authorized official
• Justin Dutton DMD PC

  dba CopperMine Dental Studio

  • Dentist
  • Sahuarita, AZ
  • NPI 1386126548
  NPD Authorized official
• Coppermine Madera Canyon LLC

  dba Coppermine Dental Studio

  • General Practice Dentistry
  • Green Valley, AZ
  • NPI 1679326938
  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1033186556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15920 S RANCHO SAHUARITA BLVD STE 100",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856298013",
            "telephone_number": "520-838-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15920 S RANCHO SAHUARITA BLVD",
            "address_2": "SUITE ONE HUNDRED",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856298012",
            "telephone_number": "520-838-0600",
            "fax_number": "520-838-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ODB23DUTTJU1",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "582579",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adam Keith Edwards, M.D.
• Pamela Klima Ellis, OTR
• Favor & Grace Inc (Favor & Grace Children Behavioral Group Home)
• Flourish in Life Inc

• Dentist in Sahuarita, AZ
• Providers in Sahuarita, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.