Individual provider Active NPI

Anthony Fernando Reynoso Quihuis

  • Dentist
  • Tucson, AZ
National Provider Identifier
1295083780
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8555 Issued in AZ
Practice address
5977 E Grant Rd Ste 115
Tucson, AZ 85712-2341
Phone
(520) 733-0040
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8555 AZ Primary

Addresses

Primary practice location

5977 E Grant Rd Ste 115
Tucson, AZ 85712-2341

Mailing address

3750 E Via Palomita Apt 8103
Tucson, AZ 85718-3373
Phone (480) 310-1478

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
I20150624002460 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4981915444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8555AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Dental Arts PLLC Current Accepting new patients
An Elegant Smile P.C. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1295083780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 E VIA PALOMITA APT 8103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857183373",
            "telephone_number": "480-310-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5977 E GRANT RD STE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122341",
            "telephone_number": "520-733-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIHUIS",
        "first_name": "ANTHONY",
        "middle_name": "FERNANDO REYNOSO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.