Luis Enrique Medina Torres, DMD, MS
Individual provider Active NPI Endodontics · Phoenix, AZ
NPI 1235628538 · NPPES record last updated Jul 6, 2023
Key facts
- NPI
- 1235628538
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- D011703 (AZ)
- Practice address
- 4141 N 32ND St Ste 100
Phoenix, AZ 85018-4775 - Phone
- (602) 404-3800
- NPI assigned
- May 2, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230626002784 | AZ | Order and Referring Only - Dentist |
1557729373 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Valley Endodontics, P.a. | Endodontics | Current |
Accepting new patients |
Locations
2979 W Elliot Rd
Ste 4
Chandler, AZ 85224
Phone (480) 775-1300
20100 N 51st Ave
Ste C310
Glendale, AZ 85308
Phone (623) 572-4300
14155 N 83rd Ave
Ste 141
Peoria, AZ 85381
Phone (623) 878-1000
702 E Bell Rd
Ste 111
Phoenix, AZ 85022
Phone (602) 404-3800
4141 N 32nd St
Ste 100
Phoenix, AZ 85018
Phone (602) 404-3800
8121 E Indian Bend Rd
Ste 128
Scottsdale, AZ 85250
7281 E Earll Dr
Ste 1
Scottsdale, AZ 85251
Phone (480) 634-4013
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Endodontics | 1223E0200X | D011703 | AZ | Yes |
Addresses
Primary practice location
4141 N 32ND St Ste 100
Phoenix, AZ 85018-4775
Mailing address
8121 E Indian Bend Rd Ste 128
Scottsdale, AZ 85250-4820
Phone (602) 482-7000
Other names
- Luis Enrique Medina-Torres
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.