Individual provider Active NPI

Allison Daugherty

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1235903147
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D012310 Issued in AZ
Practice address
4757 E Greenway Rd Ste 108
Phoenix, AZ 85032-8510
Phone
(602) 844-9601
Fax
(602) 338-9081
NPI assigned
Nov 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 D012310 AZ Primary

Addresses

Primary practice location

4757 E Greenway Rd Ste 108
Phoenix, AZ 85032-8510

Mailing address

20100 N 78TH PL Apt 2060
Scottsdale, AZ 85255-3837

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D012310AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1235903147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20100 N 78TH PL APT 2060",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852553837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 E GREENWAY RD STE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850328510",
            "telephone_number": "602-844-9601",
            "fax_number": "602-338-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-10",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.