Individual provider Active NPI

Javier M Tapia

  • Dentist
  • Tucson, AZ
National Provider Identifier
1164161964
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011379 Issued in AZ
Practice address
3603 W Cortaro Rd
Suite 113
Tucson, AZ 85742
Phone
(520) 572-1593
NPI assigned
May 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D011379 AZ Primary

Addresses

Primary practice location

3603 W Cortaro Rd
Suite 113
Tucson, AZ 85742

Mailing address

1094 Vista de Los Alamos
Rio Rico, AZ 85648-1712
Phone (520) 572-1593

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
I20251002002785 AZ Practitioner - Dentist 1658877287

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Western University of Health Sciences College of Dental Med, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

825 N Grand Ave
Suite 100
Nogales, AZ 85621-2385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D011379AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc CurrentSince Jul 20, 2025 Accepting new patients
Mariposa Community Health Center, Inc Current Accepting new patients
Mariposa Community Health Center, Inc CurrentSince Jul 20, 2025 Accepting new patients
TMJ Dental, PLLC Current Accepting new patients

Locations

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

1852 N Mastick Way
Nogales, AZ 85621

1103 Circulo Mercado
Rio Rico, AZ 85648
Phone 5202811550 ext. 1180

Organizations & group practices 4

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1164161964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 VISTA DE LOS ALAMOS",
            "city": "RIO RICO",
            "state": "AZ",
            "postal_code": "856481712",
            "telephone_number": "520-572-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3603 W CORTARO RD",
            "address_2": "SUITE 113",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85742",
            "telephone_number": "520-572-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPIA",
        "first_name": "JAVIER",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.