Individual provider Active NPI

Joseph Donovan Tenney, D.D.S.

  • Dentist
  • Saint Johns, AZ
National Provider Identifier
1063604965
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7350 Issued in AZ
Practice address
100 North 13TH West
Saint Johns, AZ 85936
Phone
(928) 337-2522
Fax
(928) 337-4881
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7350 AZ Primary

Addresses

Primary practice location

100 North 13TH West
Saint Johns, AZ 85936

Mailing address

PO Box 930
100 North 13TH West
Saint Johns, AZ 85936-0930
Phone (928) 337-2522

Other identifiers 1

IdentifierTypeStateIssuer
D7350OtherAZDENTAL STATE LICENSE #

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
D7350AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Randolph P Platt DDS, PC General Practice Past Accepting new patients
Hancock Comprehensive Dentistry General Practice PastSince Jun 23, 2024 Accepting new patients
Nicholas T Mallory DMD PLLC General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1063604965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "address_2": "100 NORTH 13TH WEST",
            "city": "SAINT JOHNS",
            "state": "AZ",
            "postal_code": "859360930",
            "telephone_number": "928-337-2522",
            "fax_number": "928-337-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH 13TH WEST",
            "city": "SAINT JOHNS",
            "state": "AZ",
            "postal_code": "85936",
            "telephone_number": "928-337-2522",
            "fax_number": "928-337-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNEY",
        "first_name": "JOSEPH",
        "middle_name": "DONOVAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL STATE LICENSE #",
            "identifier": "D7350",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.