Active NPI
Michelle Rock, DDS
- General Practice Dentistry
- Mesa, AZ
National Provider Identifier
1366416836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D5422
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150425000381 | AZ | Order and Referring Only - Oral Surgery | 4587983556 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D5422 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Practice Dentistry
- Mesa, AZ
- NPI 1952461998
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.