Individual provider Active NPI

Alexander B McRae, DDS

  • General Practice Dentistry
  • Green Valley, AZ
National Provider Identifier
1285755215
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AZ1562 Issued in AZ
Practice address
267 W Duval Rd
Ste. 105
Green Valley, AZ 85614-4344
Phone
(520) 625-0131
Fax
(520) 625-6998
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AZ1562 AZ Primary

Addresses

Primary practice location

267 W Duval Rd
Ste. 105
Green Valley, AZ 85614-4344

Mailing address

267 W Duval Rd
Ste. 105
Green Valley, AZ 85614-4344
Phone (520) 625-0131

Other identifiers 1

IdentifierTypeStateIssuer
AZ1562OtherAZDENTAL LICENSE

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
AZ1562AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dawnie L. Kildoo PA General Practice 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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285755215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 W DUVAL RD",
            "address_2": "STE. 105",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144344",
            "telephone_number": "520-625-0131",
            "fax_number": "520-625-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 W DUVAL RD",
            "address_2": "STE. 105",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144344",
            "telephone_number": "520-625-0131",
            "fax_number": "520-625-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "ALEXANDER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ1562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "AZ1562",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.