Active NPI
Valentino James Pugnea, D.D.S.
- General Practice Dentistry
- Tucson, AZ
National Provider Identifier
1205958568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2851
- Practice address
- 404 N Alvernon Way
Tucson, AZ 85711-1952 - Phone
- (520) 326-2725
- Fax
- (520) 881-5911
- NPI assigned
- Apr 5, 2007
- 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 | 2851 | AZ | Primary |
Addresses
Primary practice location
404 N Alvernon Way
Tucson, AZ 85711-1952
Mailing address
404 N Alvernon Way
Tucson, AZ 85711-1952
Phone (520) 326-2725
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614000325 | AZ | Order and Referring Only - Dentist | 3274824792 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2851 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skin Concierge, LLC. | 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.
-
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- Tucson, AZ
- NPI 1497270664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205958568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 N ALVERNON WAY",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857111952",
"telephone_number": "520-326-2725",
"fax_number": "520-881-5911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 N ALVERNON WAY",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857111952",
"telephone_number": "520-326-2725",
"fax_number": "520-881-5911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGNEA",
"first_name": "VALENTINO",
"middle_name": "JAMES",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "2851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- 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.