Active NPI
James Clinton Goodwin, DMD
- Dentist
- Oro Valley, AZ
National Provider Identifier
1366495087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- AZ03540
- Practice address
- 10134 N Oracle Rd Ste 170
Oro Valley, AZ 85704-7612 - Phone
- (520) 848-3889
- Fax
- (520) 989-3134
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | AZ03540 | AZ | Primary |
Addresses
Primary practice location
10134 N Oracle Rd Ste 170
Oro Valley, AZ 85704-7612
Mailing address
10134 N Oracle Rd Ste 170
Oro Valley, AZ 85704-7612
Phone (520) 848-3889
Other practice location 1
8841 E Florentine Rd Ste E
Prescott Valley, AZ 86314-8776
Phone (928) 778-4555
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 |
|---|---|---|---|---|
| I20110316000622 | AZ | Practitioner - Oral Surgery | 1850416215 | Practice locations: Prescott Valley, AZ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AZ03540 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleepmatters, PLC | Current | Accepting new patients | |
| Ashvin K. Shah, M.D., PC | Past | Accepting new patients |
Locations
10134 N Oracle Rd
Ste 170
Tucson, AZ 85704
Phone (520) 848-3889
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Oro Valley, AZ
- NPI 1356094924
-
- Sleep Medicine (Internal Medicine) Physician
- Yuma, AZ
- NPI 1992915284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1366495087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10134 N ORACLE RD STE 170",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857047612",
"telephone_number": "520-848-3889",
"fax_number": "520-989-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10134 N ORACLE RD STE 170",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857047612",
"telephone_number": "520-848-3889",
"fax_number": "520-989-3134"
}
],
"practiceLocations": [
{
"address_1": "8841 E Florentine Rd Ste E",
"address_purpose": "LOCATION",
"city": "Prescott Valley",
"state": "AZ",
"postal_code": "863148776",
"country_code": "US",
"telephone_number": "928-778-4555",
"fax_number": "928-778-4560",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOODWIN",
"first_name": "JAMES",
"middle_name": "CLINTON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "AZ03540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oro Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.