Scott Edward Nuessle, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5728 Issued in AZ

Practice address

E. on Hwy 160 to Rte 59 Behind Chapter
Kayenta, AZ 86033

Phone

(928) 697-8154

Fax

(928) 697-8559

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1245459478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1625",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860401625",
            "telephone_number": "928-645-9675",
            "fax_number": "928-645-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E. ON HWY 160 TO RTE 59 BEHIND CHAPTER",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-8154",
            "fax_number": "928-697-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESSLE",
        "first_name": "SCOTT",
        "middle_name": "EDWARD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852104",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uriah Jamison Morris, REGISTERED NURSE
• Xavier Kelton Nelson, MEDICAL TECHNOLOGIST
• John Quoc Nguyen, PHARMD
• Kim Thi Nguyen, PHARM.D.
• Emily Ingram Nimon, REGISTERED NUSE
• Sharon Lee Oaks, RN
• Romancelita Benally Paul, CLS
• Terrell Paul, CLS, ASCP
• Jereesha Shaunta Peacock
• Vinh Phu Pham, RPH

• General Practice Dentistry in Kayenta, AZ
• Providers in Kayenta, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.

Verify at the official NPI Registry.