Individual provider Active NPI

Kathleen C. Green Naughton, DMD

  • Dentist
  • Paradise Valley, AZ
National Provider Identifier
1265615033
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5132 Issued in AZ
Practice address
5134 N 69TH PL
Paradise Valley, AZ 85253-7001
Phone
(602) 499-6933
NPI assigned
Dec 14, 2007
Last updated
Dec 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 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 19365 MA
Dentist 122300000X 5132 AZ Primary

Addresses

Primary practice location

5134 N 69TH PL
Paradise Valley, AZ 85253-7001

Mailing address

5134 N 69TH PL
Paradise Valley, AZ 85253-7001
Phone (602) 499-6933

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160928000379 AZ Order and Referring Only - DentistPractitioner - Dentist 3375830896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19365MAMDDentist
5132AZMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1265615033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5134 N 69TH PL",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852537001",
            "telephone_number": "602-499-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5134 N 69TH PL",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852537001",
            "telephone_number": "602-499-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN NAUGHTON",
        "first_name": "KATHLEEN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "19365",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise Valley, AZ

Sources for this page

Verify at the official NPI Registry.