Steven Nicholas Booth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4462 Issued in AZ

Practice address

120 E Main St Ste B
Payson, AZ 85541-5618

Phone

(928) 474-4789

Fax

(928) 474-9838

NPI assigned

Sep 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chelani Productions, LLC

  dba Gabbert Medical

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1417768110
  NPD (past)
• Regenthetics, LLC

  • Pain Clinic/Center
  • Payson, AZ
  • NPI 1932717550
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174628218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E MAIN ST STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415618",
            "telephone_number": "928-474-4789",
            "fax_number": "928-474-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E MAIN ST STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415618",
            "telephone_number": "928-474-4789",
            "fax_number": "928-474-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "STEVEN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Blasko, FNP-C
• Tyri Norman Blondal, LMSW
• Sheila Eva Bloomquist, MD
• Bonanza Square Dentistry LLC
• Cynthia D Booth, MD
• Gerald Bossert, PA
• Bruce Boushon, RPH
• Robin Bramble, FNP-BC
• Alyson Kanani Brown, MA, LPCA
• Michael Evan Brown, MD

• General Practice Dentistry in Payson, AZ
• Providers in Payson, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.