Active NPI
Dallyn Porter Udall, DO
- Adult Reconstructive Orthopaedic Surgery Physician
- Gilbert, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Reconstructive Orthopaedic Surgery Physician
- License
- 011544
- Practice address
- 2940 E Banner Gateway Dr Ste 200-250
Gilbert, AZ 85234-2168 - Phone
- (602) 648-5444
- Fax
- (602) 772-3801
- NPI assigned
- May 9, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 20A19340 | CA | |
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 20A19340 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 011544 | AZ | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 011544 | AZ |
Addresses
Primary practice location
2940 E Banner Gateway Dr Ste 200-250
Gilbert, AZ 85234-2168
Mailing address
PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115
Other practice location 1
10710 N Torrey Pines Rd
LA Jolla, CA 92037-1035
Phone (858) 554-7993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1675 E Melrose St
Suite 101 103
Gilbert, AZ 85297-1001
Phone (602) 631-3161
Hospital & facility affiliations
- Mercy Gilbert Medical Center
- Arizona Spine and Joint Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 44 |
| Knee replacement | 58 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A19340 | CA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Orthopedic Specialists of North America, PLLC | Orthopaedic Surgery | Current | Accepting new patients |
| Orthopedic Specialists of North America PLLC | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Orthopedic Specialists of North America, PLLC | Orthopaedic Surgery | Current | Accepting new patients |
| Arizona Spine and Joint Hospital LLC | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
525 S Chandler Village Dr
Chandler, AZ 85226
Phone (480) 750-0303
2940 E Banner Gateway Dr
Ste 200250
Gilbert, AZ 85234
1675 E Melrose St
Gilbert, AZ 85297
Phone (480) 519-8100
1675 E Melrose St
Ste 101103
Gilbert, AZ 85297
Phone (602) 631-3161
2940 E Banner Gateway Dr
Ste 200
Gilbert, AZ 85234
2355 E Camelback Rd
Ste 325
Phoenix, AZ 85016
Phone (602) 772-3795
40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140
5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
Interoperability endpoints
- dallynudall@asjh.medalliesdirect.net
- dudall146552@direct.llu.edu
Organizations & group practices 7
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.
-
- Orthopaedic Surgery Physician
- Phoenix, AZ
- NPI 1770812828
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- General Acute Care Hospital
- Mesa, AZ
- NPI 1396745832
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1689273542
-
- Orthopaedic Surgery Physician
- Gilbert, AZ
- NPI 1962292870
-
- Health Maintenance Organization
- Hemet, CA
- NPI 1013433465
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mesa, AZ
- NPI 1396745832
-
- General Acute Care Hospital
- Gilbert, AZ
- NPI 1992735088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746144000000",
"number": "1164088605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80217",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850600217",
"telephone_number": "602-385-2115",
"fax_number": "480-418-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 E BANNER GATEWAY DR STE 200-250",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342168",
"telephone_number": "602-648-5444",
"fax_number": "602-772-3801"
}
],
"practiceLocations": [
{
"address_1": "10710 N Torrey Pines Rd",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920371035",
"country_code": "US",
"telephone_number": "858-554-7993",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UDALL",
"first_name": "DALLYN",
"middle_name": "PORTER",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-09",
"last_updated": "2025-05-02",
"certification_date": "2025-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "20A19340",
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "CA",
"license": "20A19340",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "AZ",
"license": "011544",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AZ",
"license": "011544",
"primary": false
}
],
"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 May 2, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.