Individual provider Active NPI

Dana A Perno, DDS

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1306961586
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D05999 Issued in AZ
Practice address
3003 N Central Ave Ste 630
Phoenix, AZ 85012-2905
Phone
(602) 230-1161
NPI assigned
Mar 20, 2007
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D05999 AZ Primary

Addresses

Primary practice location

3003 N Central Ave Ste 630
Phoenix, AZ 85012-2905

Mailing address

3003 N Central Ave Ste 630
Phoenix, AZ 85012-2905
Phone (602) 230-1161

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
D05999AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
SP Dental General Practice CurrentSince Mar 12, 2023 Accepting new patients
Kimiko Management, LLC General Practice Past Accepting new patients
Joseph H Davis DDS PC Dentist PastSince Mar 12, 2023 Accepting new patients

Locations

3003 N Central Ave
Ste 630
Phoenix, AZ 85012
Phone (602) 230-1161

Organizations & group practices 3

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1306961586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 630",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122905",
            "telephone_number": "602-230-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 630",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122905",
            "telephone_number": "602-230-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNO",
        "first_name": "DANA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D05999",
            "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 Mar 8, 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.