Individual provider Active NPI

Sarina I Ullis, DMD

  • Dentist
  • Nogales, AZ
National Provider Identifier
1316833072
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D012548 Issued in AZ
Practice address
1852 N Mastick Way
Nogales, AZ 85621-1063
Phone
(520) 375-5032
Fax
(520) 281-4487
NPI assigned
Jun 17, 2025
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D012548 AZ Primary

Addresses

Primary practice location

1852 N Mastick Way
Nogales, AZ 85621-1063

Mailing address

825 N Grand Ave Ste 100
Nogales, AZ 85621-1061
Phone (520) 761-2128

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
I20250819002258 AZ Practitioner - Dentist 5890294532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Midwestern University College of Dental Medicine, Glendale, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

825 N Grand Ave
Suite 100
Nogales, AZ 85621-2385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc Current Accepting new patients
Mariposa Community Health Center, Inc CurrentSince Sep 1, 2025 Accepting new patients
Mariposa Community Health Center, Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

1852 N Mastick Way
Nogales, AZ 85621

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

1103 Circulo Mercado
Rio Rico, AZ 85648
Phone 5202811550 ext. 1180

1103 Circulo Mercado
Ste 3
Rio Rico, AZ 85648

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1316833072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-761-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211063",
            "telephone_number": "520-375-5032",
            "fax_number": "520-281-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLIS",
        "first_name": "SARINA",
        "middle_name": "I",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

Verify at the official NPI Registry.