Theresa M. Collins, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D009063 Issued in AZ

Practice address

2058 S Dobson Rd
Ste 12
Mesa, AZ 85202-6454

Phone

(503) 267-7559

NPI assigned

Jul 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cactus Canyon Dental

  • General Practice Dentistry
  • Tempe, AZ
  • NPI 1346893575
  NPD (past) Authorized official

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1093061202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 S DOBSON RD",
            "address_2": "STE 12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026454",
            "telephone_number": "503-267-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2058 S DOBSON RD",
            "address_2": "STE 12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026454",
            "telephone_number": "503-267-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "THERESA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9756",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Michelle Collins
• Karina Collins
• Matthew Collins
• Rayanna Marie Collins, OTA-046959
• Terri Collins, NP
• Biagio James Collura, MD
• Allison Lillian Colman
• Samantha Colone
• Colorado Spine Inovations
• Abrianna Elizabeth Colossio, PHD, LPC

• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.