Roy Gwenn Daniels, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3155 Issued in AZ

Practice address

2235 Corral Rd
Sedona, AZ 86336-3272

Phone

(928) 300-3546

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 4, 2024.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707004800000",
    "number": "1073674214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CORRAL RD",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863363272",
            "telephone_number": "928-300-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 CORRAL RD",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863363272",
            "telephone_number": "928-300-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "ROY",
        "middle_name": "GWENN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "3155",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "3155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sedona, AZ
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.