Active NPI
Marc S Kay, DDJ
- Dentist
- Phoenix, AZ
National Provider Identifier
1306931399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3243
- Practice address
- 5225 N 19TH Ave
#C
Phoenix, AZ 85015 - Phone
- (602) 433-0313
- Fax
- (602) 433-9343
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3243 | AZ | Primary |
Addresses
Primary practice location
5225 N 19TH Ave
#C
Phoenix, AZ 85015
Mailing address
5225 N 19TH Ave
#C
Phoenix, AZ 85015
Phone (602) 433-0313
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3243 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A 19TH Avenue Dental Care | Dentist | 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.
-
- Dentist
- Phoenix, AZ
- NPI 1356501662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306931399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5225 N 19TH AVE",
"address_2": "#C",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85015",
"telephone_number": "602-433-0313",
"fax_number": "602-433-9343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 N 19TH AVE",
"address_2": "#C",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85015",
"telephone_number": "602-433-0313",
"fax_number": "602-433-9343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAY",
"first_name": "MARC",
"middle_name": "S",
"credential": "DDJ",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "3243",
"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 8, 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.