Individual provider Active NPI

Harry Wayne Chesser Jr., DDS

  • Dentist
  • Prescott, AZ
National Provider Identifier
1336756865
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D010880 Issued in AZ
Practice address
222 S Summit Ave Ste 2
Prescott, AZ 86303-3780
Phone
(970) 852-0055
NPI assigned
Sep 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D010880 AZ
Dentist 122300000X D010880 AZ Primary

Addresses

Primary practice location

222 S Summit Ave Ste 2
Prescott, AZ 86303-3780

Mailing address

7575 N Outlook LN
Prescott Valley, AZ 86315-4591
Phone (970) 852-0055

Other practice location 1

13802 W Camino Del Sol Ste 101
Sun City West, AZ 85375-4486
Phone (623) 583-0151

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
I20201021003273 AZ Order and Referring Only - DentistPractitioner - Dentist 1658791116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D010880AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew J Harmon DMD PLLC General Practice CurrentSince Mar 1, 2022 Accepting new patients
H. Wayne Chesser DDS PLLC CurrentSince Dec 24, 2023 Accepting new patients
Cortaro Smiles and Orthodontics, LLP General Practice PastSince Oct 1, 2020 Accepting new patients

Locations

222 S Summit Ave
Ste 2
Prescott, AZ 86303
Phone (928) 445-2440

13802 W Camino del Sol
Ste 101
Sun City West, AZ 85375
Phone (623) 583-0151

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1336756865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 N OUTLOOK LN",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863154591",
            "telephone_number": "970-852-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S SUMMIT AVE STE 2",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863033780",
            "telephone_number": "970-852-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13802 W Camino Del Sol Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853754486",
            "country_code": "US",
            "telephone_number": "623-583-0151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHESSER",
        "first_name": "HARRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010880",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.