Individual provider Active NPI

Reem Kidess, D.D.S.

  • Dentist
  • Paradise Valley, AZ
National Provider Identifier
1326257841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D6741 Issued in AZ
Practice address
7125 E Lincoln Dr Ste a-105
Paradise Valley, AZ 85253-4429
Phone
(480) 991-2290
NPI assigned
May 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D6741 AZ Primary

Addresses

Primary practice location

7125 E Lincoln Dr Ste a-105
Paradise Valley, AZ 85253-4429

Mailing address

7125 E Lincoln Dr Ste a-105
Paradise Valley, AZ 85253-4429
Phone (480) 991-2290

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
I20160506000749 AZ Order and Referring Only - DentistPractitioner - Dentist 2567761943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D6741AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326257841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 E LINCOLN DR STE A-105",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852534429",
            "telephone_number": "480-991-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 E LINCOLN DR STE A-105",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852534429",
            "telephone_number": "480-991-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDESS",
        "first_name": "REEM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D6741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise Valley, AZ

Sources for this page

Verify at the official NPI Registry.