Individual provider Active NPI

Nathan Palmer Tenney, D.M.D.

  • Dentist
  • Glendale, AZ
National Provider Identifier
1144652009
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29099 Issued in TX
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

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
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215002862 AZ Order and Referring Only - DentistPractitioner - Dentist 0749584233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D009671AZMDDentist
29099TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan P Tenney DMD, PLLC Current Accepting new patients
Dental Apnea Professionals PLLC CurrentSince Mar 1, 2021 Accepting new patients
Desert Sky Dental Partners LLC PastSince Feb 18, 2024 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.

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

Verify at the official NPI Registry.