Individual provider Active NPI

Richard Jay Handelman, DDS

  • Dentist
  • Anthem, AZ
National Provider Identifier
1063456606
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
009418 Issued in AZ
Practice address
39422 N Daisy Mountain Dr
Anthem, AZ 85086-6703
Phone
(623) 277-5002
NPI assigned
Jun 15, 2006
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 009418 AZ Primary

Addresses

Primary practice location

39422 N Daisy Mountain Dr
Anthem, AZ 85086-6703

Mailing address

7025 E Via Soleri Dr
1045
Scottsdale, AZ 85251-1266
Phone (719) 661-0017

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

State licenses

LicenseStateTypeSpecialty
009418AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Dental Anthem PLLC Dentist CurrentSince Jan 7, 2024 Accepting new patients
Intermountain Companies Dentist Past Accepting new patients
Modern Dental Professionals Az, PC Past Accepting new patients

Locations

39422 N Daisy Mountain Dr
Anthem, AZ 85086
Phone (623) 277-5002

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1063456606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 E VIA SOLERI DR",
            "address_2": "1045",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852511266",
            "telephone_number": "719-661-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39422 N DAISY MOUNTAIN DR",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850866703",
            "telephone_number": "623-277-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANDELMAN",
        "first_name": "RICHARD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "009418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthem, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.