Individual provider Active NPI

Clara Mutale, D.M.D.

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1255354213
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7129 Issued in AZ
Practice address
2175 N Alma School Rd
C-108
Chandler, AZ 85224-2878
Phone
(480) 782-6200
Fax
(480) 792-1444
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13405 MD
General Practice Dentistry 1223G0001X D7129 AZ Primary

Addresses

Primary practice location

2175 N Alma School Rd
C-108
Chandler, AZ 85224-2878

Mailing address

261 W Wisteria PL
Chandler, AZ 85248-4027
Phone (480) 250-2419

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

LicenseStateTypeSpecialty
13405MDMDDentist
D7129AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sun West Dental Chandler Past Accepting new patients
Tran Dental GRP. LLC General Practice Past Accepting new patients
Sun West Dental III, LLC Dba Sun West Dental Dentist PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1255354213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 W WISTERIA PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852484027",
            "telephone_number": "480-250-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 N ALMA SCHOOL RD",
            "address_2": "C-108",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242878",
            "telephone_number": "480-782-6200",
            "fax_number": "480-792-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTALE",
        "first_name": "CLARA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13405",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.