Active NPI
Neil S. Reiser, DDS
- General Practice Dentistry
- Mesa, AZ
National Provider Identifier
1205924214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2937
- Practice address
- 3050 S Country Club Dr Ste 18
Mesa, AZ 85210-8365 - Phone
- (480) 892-8185
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2937 | AZ | Primary |
Addresses
Primary practice location
3050 S Country Club Dr Ste 18
Mesa, AZ 85210-8365
Mailing address
5648 Ew Desert Forest Trail
Cave Creek, AZ 85331
Phone (480) 892-8185
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182444 | Other | AZ | AHCESS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2937 | AZ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Country Club Dental Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Mesa, AZ
- NPI 1417121880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451952000000",
"number": "1205924214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5648 EW DESERT FOREST TRAIL",
"city": "CAVE CREEK",
"state": "AZ",
"postal_code": "85331",
"telephone_number": "480-892-8185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3050 S COUNTRY CLUB DR STE 18",
"city": "MESA",
"state": "AZ",
"postal_code": "852108365",
"telephone_number": "480-892-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISER",
"first_name": "NEIL",
"middle_name": "S.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2016-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "2937",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCESS",
"identifier": "182444",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.