Active NPI
Heidi Prince Phelps, RDH
- Dental Hygienist
- Gilbert, AZ
National Provider Identifier
1124886650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5603
- Practice address
- 3916 E Rawhide St
Gilbert, AZ 85296-1826 - Phone
- (480) 415-3530
- NPI assigned
- Mar 11, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | |||
| Dental Hygienist | 124Q00000X | 5603 | AZ | Primary |
Addresses
Primary practice location
3916 E Rawhide St
Gilbert, AZ 85296-1826
Mailing address
3916 E Rawhide St
Gilbert, AZ 85296-1826
Phone (480) 415-3530
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5603 | AZ | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1124886650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3916 E RAWHIDE ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852961826",
"telephone_number": "480-415-3530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3916 E RAWHIDE ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852961826",
"telephone_number": "480-415-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "HEIDI",
"middle_name": "PRINCE",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-11",
"last_updated": "2024-03-11",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "5603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.