Individual provider Active NPI

Nathan John Hinckley, DDS

  • Endodontics
  • Peoria, AZ
National Provider Identifier
1083926992
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D009780 Issued in AZ
Practice address
8085 W Bell Rd Ste 103
Peoria, AZ 85382-3825
Phone
(623) 878-5400
NPI assigned
Jul 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6226 OK
Endodontics 1223E0200X D009780 AZ Primary

Addresses

Primary practice location

8085 W Bell Rd Ste 103
Peoria, AZ 85382-3825

Mailing address

2834 E Preston St
Mesa, AZ 85213-1926
Phone (405) 651-5889

Other practice location 1

500 W. Main, Suite 200
Norman, OK 73069
Phone (405) 321-6076

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6226OKMDClinical Social Worker
D009780AZMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan J Hinckley DDS a Professional Dental Corporation Endodontics Current Accepting new patients
Arrowhead Dental Group and Orthodontics, LLP General Practice Past Accepting new patients

Organizations & group practices 2

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083926992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 E PRESTON ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852131926",
            "telephone_number": "405-651-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8085 W BELL RD STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823825",
            "telephone_number": "623-878-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W. Main, Suite 200",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "73069",
            "country_code": "US",
            "telephone_number": "405-321-6076",
            "fax_number": "405-321-3830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINCKLEY",
        "first_name": "NATHAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6226",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D009780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.