Active NPI
Gregory Lord, DMD
- Dentist
- Mesa, AZ
National Provider Identifier
1043337694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10504
- Practice address
- 5835 E Still Cir
Mesa, AZ 85206-3618 - Phone
- (480) 248-8100
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019026521 | IL | |
| Dentist | 122300000X | 7950 | KY | |
| Dentist | 122300000X | 10504 | AZ | Primary |
Addresses
Primary practice location
5835 E Still Cir
Mesa, AZ 85206-3618
Mailing address
5835 E Still Cir
Mesa, AZ 85206-3618
Phone (480) 248-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- University of Louisville School of Dentistry, 2003
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 787
Peridot, AZ 85542
PO Box
Suite 787
Peridot, AZ 85542-0787
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10504 | AZ | MD | Dentist |
| 019026521 | IL | MD | Dentist |
Organizations & group practices 1
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.
-
- Critical Access Hospital Clinic/Center
- Peridot, AZ
- NPI 1265813075
TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761523200000",
"number": "1043337694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5835 E STILL CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852063618",
"telephone_number": "480-248-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5835 E STILL CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852063618",
"telephone_number": "480-248-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORD",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019026521",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "7950",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "10504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.