Tammy Ky, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012269 Issued in AZ

Practice address

21001 N Tatum Blvd Ste 80-1690
Phoenix, AZ 85050-5233

Phone

(480) 419-9200

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 and National Provider Directory roles.

• Marketplace Smiles, LLP

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1518052216
  NPD (past)
• Sambangi and Rodgers Dental Corporation

  • General Practice Dentistry
  • Chino, CA
  • NPI 1639322001
  NPD (past)

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1194440339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N 44TH ST UNIT 2041",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850085775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 80-1690",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850505233",
            "telephone_number": "480-419-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KY",
        "first_name": "TAMMY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108188",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajiv Kwatra, MD
• Kwon MD, Inc
• Mandy Kwon, NP
• Christina Grace Kwong, MD
• Henry Mark Kwong Jr., MD
• Trung Quang Ky, PHARMD
• Kyle Pohlman Chiropractic
• Loretta Kyler
• Billy D Kyles, LMSW
• Montoya Billy Kyles, LCSW

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, 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 31, 2024; 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.