Individual provider Active NPI

Michelle T Villanueva, DDS

  • General Practice Dentistry
  • Queen Creek, AZ
National Provider Identifier
1366536823
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6398 Issued in AZ
Practice address
21321 E Ocotillo Rd Ste 112
Queen Creek, AZ 85142-5993
Phone
(480) 882-9710
Fax
(480) 882-9706
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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 D6398 AZ Primary

Addresses

Primary practice location

21321 E Ocotillo Rd Ste 112
Queen Creek, AZ 85142-5993

Mailing address

21321 E Ocotillo Rd
Queen Creek, AZ 85142-5996
Phone (480) 882-9710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D6398AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cooley Station Kids Dentist and Orthodontics, LLP 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1366536823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425996",
            "telephone_number": "480-882-9710",
            "fax_number": "480-882-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 112",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425993",
            "telephone_number": "480-882-9710",
            "fax_number": "480-882-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "MICHELLE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.