Individual provider Active NPI

John S Coleman, D.M.D.

  • General Practice Dentistry
  • Gilbert, AZ
National Provider Identifier
1194817262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5646 Issued in AZ
Practice address
3011 S Lindsay Rd
#104
Gilbert, AZ 85296-0701
Phone
(480) 855-5544
Fax
(480) 855-7889
NPI assigned
Sep 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5646 AZ Primary

Addresses

Primary practice location

3011 S Lindsay Rd
#104
Gilbert, AZ 85296-0701

Mailing address

3011 S Lindsay Rd
#104
Gilbert, AZ 85296-0701
Phone (480) 855-5544

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
I20161107001308 AZ Order and Referring Only - DentistPractitioner - Dentist 8022396415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194817262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 S LINDSAY RD",
            "address_2": "#104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852960701",
            "telephone_number": "480-855-5544",
            "fax_number": "480-855-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 S LINDSAY RD",
            "address_2": "#104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852960701",
            "telephone_number": "480-855-5544",
            "fax_number": "480-855-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.