NPIMap

Individual provider Active NPI

Mandy Daitch, D.D.S.

  • General Practice Dentistry
  • Glendale, AZ
National Provider Identifier
1033224829
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5465 Issued in AZ
Practice address
6320A W Union Hills Dr
Suite #280
Glendale, AZ 85308-7177
Phone
(623) 362-1150
Fax
(623) 362-1353
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5465 AZ Primary

Addresses

Primary practice location

6320A W Union Hills Dr
Suite #280
Glendale, AZ 85308-7177

Mailing address

6320A W Union Hills Dr
Suite #280
Glendale, AZ 85308-7177
Phone (623) 362-1150

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arthur Orthodontics, PLC Past Accepting new patients
Affilliated Children'S Dental Specialists Pediatric Dentistry 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033224829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320A W UNION HILLS DR",
            "address_2": "SUITE #280",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087177",
            "telephone_number": "623-362-1150",
            "fax_number": "623-362-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320A W UNION HILLS DR",
            "address_2": "SUITE #280",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087177",
            "telephone_number": "623-362-1150",
            "fax_number": "623-362-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAITCH",
        "first_name": "MANDY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.