Individual provider Active NPI

Michelle Rock, DDS

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1366416836
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5422 Issued in AZ
Practice address
9937 E Baseline Rd Ste 104
Mesa, AZ 85209-8330
Phone
(480) 615-8585
Fax
(480) 615-8686
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D5422 AZ Primary

Addresses

Primary practice location

9937 E Baseline Rd Ste 104
Mesa, AZ 85209-8330

Mailing address

9937 E Baseline Rd Ste 104
Mesa, AZ 85209-8330
Phone (480) 615-8585

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
I20150425000381 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587983556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5422AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eastridge Family Dentistry, Inc. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1366416836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9937 E BASELINE RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852098330",
            "telephone_number": "480-615-8585",
            "fax_number": "480-615-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9937 E BASELINE RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852098330",
            "telephone_number": "480-615-8585",
            "fax_number": "480-615-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.