Randy L Mow, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D04156 Issued in AZ

Practice address

15215 S 48TH St Ste 175
Phoenix, AZ 85044-9140

Phone

(480) 759-9300

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mountain Park Dentistry L.L.C.

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1457719114
  NPD (past) Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1043388010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST STE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST STE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449140",
            "telephone_number": "480-759-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOW",
        "first_name": "RANDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4156",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D04156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Moussa, MD
• Sassan Mouzoon, DDS
• Hitesh K Movalia, M.D.
• Movewell Physical Therapy & Performance LLC
• Movewell Physical Therapy LLC
• Kristin Mowbray, LCSW-22889
• Angelina Mowery, PHARMD
• Sandra Ann Mowery, DC
• Lorin Todd Mowrey, MD
• Judy Mowry, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.