Individual provider Active NPI

Nicholas Zachary Rolfe, DMD

  • Dentist
  • Surprise, AZ
National Provider Identifier
1093600470
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D012523 Issued in AZ
Practice address
15732 W Smokey Dr
Surprise, AZ 85374-4346
Phone
(623) 258-5749
NPI assigned
Jun 9, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D012523 AZ Primary

Addresses

Primary practice location

15732 W Smokey Dr
Surprise, AZ 85374-4346

Mailing address

15732 W Smokey Dr
Surprise, AZ 85374-4346
Phone (623) 258-5749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925002825 AZ Order and Referring Only - DentistPractitioner - Dentist 8224533658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D012523AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1093600470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15732 W SMOKEY DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744346",
            "telephone_number": "623-258-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15732 W SMOKEY DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744346",
            "telephone_number": "623-258-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLFE",
        "first_name": "NICHOLAS",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.