Dvonn Annette Ponce, LMT, CA

Primary specialty

ContractorTaxonomy code 171W00000X

License

#MT-00923P Issued in AZ

Practice address

13832 N 32ND St Ste 126
Phoenix, AZ 85032-5616

Phone

(602) 493-2273

Fax

(602) 493-2159

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Longevity Medical Health Center, LLC

  • Naturopath
  • Phoenix, AZ
  • NPI 1891914594
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063535318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13832 N 32ND ST STE 126",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325616",
            "telephone_number": "602-493-2273",
            "fax_number": "602-493-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13832 N 32ND ST STE 126",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325616",
            "telephone_number": "602-493-2273",
            "fax_number": "602-493-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "DVONN",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "LMT, CA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AZ",
            "license": "#MT-00923P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Svetlana Pomirchy, PHARM D
• Kara Elizabeth Pompa, RBT
• Manuel Gerardo Pompa, PA-C
• Stephen Henry Ponas, M.D.
• Ashley Ponce, MD
• Esai Jonathon Ponce, MD
• Francisco A Ponce, MD
• Shiyu Ponciano, MD
• Casey Pond
• Diane Lea Pond, M.D.

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

• 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.