Active NPI
Nathan Palmer Tenney, D.M.D.
- Dentist
- Glendale, AZ
National Provider Identifier
1144652009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29099
- Practice address
- 18275 N 59TH Ave # C114
Glendale, AZ 85308-1260 - Phone
- (206) 978-1790
- Fax
- (602) 978-5211
- NPI assigned
- Aug 2, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D009671 | AZ | |
| Dentist | 122300000X | 29099 | TX | Primary |
Addresses
Primary practice location
18275 N 59TH Ave # C114
Glendale, AZ 85308-1260
Mailing address
9325 W Louise Dr
Peoria, AZ 85383
Phone (623) 687-7940
Other practice location 1
3650 Joe Battle Blvd
El Paso, TX 79938-2628
Phone (623) 687-7940
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211215002862 | AZ | Order and Referring Only - Dentist | 0749584233 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D009671 | AZ | MD | Dentist |
| 29099 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nathan P Tenney DMD, PLLC | Current | Accepting new patients | |
| Dental Apnea Professionals PLLC | Current | Accepting new patients | |
| Desert Sky Dental Partners LLC | Past | Accepting new patients |
Locations
18275 N 59th Ave
#C114
Glendale, AZ 85308
Phone (206) 978-1790
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Glendale, AZ
- NPI 1942775457
-
- Customized Equipment (DME)
- Glendale, AZ
- NPI 1639755085
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1427813732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1144652009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9325 W LOUISE DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "85383",
"telephone_number": "623-687-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18275 N 59TH AVE # C114",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081260",
"telephone_number": "206-978-1790",
"fax_number": "602-978-5211"
}
],
"practiceLocations": [
{
"address_1": "3650 Joe Battle Blvd",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799382628",
"country_code": "US",
"telephone_number": "623-687-7940",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TENNEY",
"first_name": "NATHAN",
"middle_name": "PALMER",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-02",
"last_updated": "2022-07-21",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D009671",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "29099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.