Active NPI
Deborah Lee Klinkefus, D.D.S.
- General Practice Dentistry
- Mesa, AZ
National Provider Identifier
1083630727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2397
- Practice address
- 30 W 1St Ave
Mesa, AZ 85210-1302 - Phone
- (480) 834-1918
- Fax
- (480) 834-1919
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2397 | AZ | Primary |
Addresses
Primary practice location
30 W 1St Ave
Mesa, AZ 85210-1302
Mailing address
30 W 1St Ave
Mesa, AZ 85210-1302
Phone (480) 834-1918
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 2, 2021 through Dec 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083630727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W 1ST AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852101302",
"telephone_number": "480-834-1918",
"fax_number": "480-834-1919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W 1ST AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852101302",
"telephone_number": "480-834-1918",
"fax_number": "480-834-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINKEFUS",
"first_name": "DEBORAH",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "2397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.