Individual provider Active NPI

John Bruno Toccafondi Jr., D.D.S., PLLC

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1265446819
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011086 Issued in AZ
Practice address
4802 E Ray Rd Ste 19
Phoenix, AZ 85044-6410
Phone
(480) 893-7733
NPI assigned
Jul 28, 2006
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 040252-1 NY
General Practice Dentistry 1223G0001X D011086 AZ Primary

Addresses

Primary practice location

4802 E Ray Rd Ste 19
Phoenix, AZ 85044-6410

Mailing address

4802 E Ray Rd Ste 19
Phoenix, AZ 85044-6410
Phone (480) 893-7733

Other practice location 1

650 W Maryland Ave Ste 1
Phoenix, AZ 85013-1399
Phone (602) 595-3600

Other practice location 2

615 Broadway
suite sw1
Hastings On Hudson, NY 10706-1039
Phone (914) 693-0199

Other practice location 3

2730 S Val Vista Dr Ste 11-164
Gilbert, AZ 85295-1680
Phone (480) 633-9977

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
D011086AZMDGeneral Practice Dentistry
040252-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew M Petersen, DDS, LLC General Practice PastSince Dec 17, 2023 Accepting new patients
Dental Arts of Hastings on Hudson PastSince Jan 26, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1265446819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 E RAY RD STE 19",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446410",
            "telephone_number": "480-893-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 E RAY RD STE 19",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446410",
            "telephone_number": "480-893-7733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 W Maryland Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850131399",
            "country_code": "US",
            "telephone_number": "602-595-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Broadway",
            "address_2": "suite sw1",
            "address_purpose": "LOCATION",
            "city": "Hastings On Hudson",
            "state": "NY",
            "postal_code": "107061039",
            "country_code": "US",
            "telephone_number": "914-693-0199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2730 S Val Vista Dr Ste 11-164",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852951680",
            "country_code": "US",
            "telephone_number": "480-633-9977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOCCAFONDI",
        "first_name": "JOHN",
        "middle_name": "BRUNO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S., PLLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-12-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040252-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011086",
            "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 13, 2023; 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.