Sharon Bader, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D5241 Issued in AZ

Practice address

9059 W Lake Pleasant Pkwy
F 600
Peoria, AZ 85382-8336

Phone

(623) 825-5595

Fax

(623) 825-5129

NPI assigned

Mar 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lake Pleasant Dentistry PC

  • Dentist
  • Peoria, AZ
  • NPI 1093172561
  NPD (past) Authorized official

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326007246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY",
            "address_2": "F 600",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828336",
            "telephone_number": "623-825-5595",
            "fax_number": "623-825-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY",
            "address_2": "F 600",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828336",
            "telephone_number": "623-825-5595",
            "fax_number": "623-825-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "SHARON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "704701",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Gregory Babineau, PHARMD
• Maddison Baca, RN, CPM
• Alissa Bachara, FNP-C
• Back to Health of Vistancia
• Joshua James Backens, PMHNP
• Terry L Bagley, M.D.
• John H Bailey, DDS
• Jamie R Bair, PA-C
• Anna Baker, MD
• Chelsea Baker, CCC-SLP

• Dentist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.