Active NPI
Samuel Irwin Dolnick, D.P.M.
- Podiatrist
- Prescott, AZ
National Provider Identifier
1073506259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0377
- Practice address
- 500 N US Highway 89
5TH Floor Surgery
Prescott, AZ 86313-5001 - Phone
- (928) 445-4860
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0377 | AZ | Primary |
Addresses
Primary practice location
500 N US Highway 89
5TH Floor Surgery
Prescott, AZ 86313-5001
Mailing address
3035 Rainbow Ridge Dr
Prescott, AZ 86303-5766
Phone (928) 443-1712
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0377 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073506259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3035 RAINBOW RIDGE DR",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863035766",
"telephone_number": "928-443-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N US HIGHWAY 89",
"address_2": "5TH FLOOR SURGERY",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863135001",
"telephone_number": "928-445-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLNICK",
"first_name": "SAMUEL",
"middle_name": "IRWIN",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AZ",
"license": "0377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.