Individual provider Active NPI

Lisa E Chinn, DMD

  • Pediatric Dentistry
  • Phoenix, AZ
National Provider Identifier
1255530952
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7221 Issued in AZ
Practice address
7006 S Central Ave
Phoenix, AZ 85042-5423
Phone
(602) 276-1029
Fax
(602) 276-1838
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 7221 AZ Primary

Addresses

Primary practice location

7006 S Central Ave
Phoenix, AZ 85042-5423

Mailing address

7006 S Central Ave
Phoenix, AZ 85042-5423
Phone (602) 276-1029

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
7221AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Valley Pediatric Dentistry Pediatric Dentistry 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.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1255530952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7006 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425423",
            "telephone_number": "602-276-1029",
            "fax_number": "602-276-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7006 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425423",
            "telephone_number": "602-276-1029",
            "fax_number": "602-276-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINN",
        "first_name": "LISA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "7221",
            "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 Jul 12, 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.