Individual provider Active NPI

Albert P Serrano, D.D.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Phoenix, AZ
National Provider Identifier
1366783060
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2814 Issued in AZ
Practice address
1515 E Missouri Ave
Suite 101
Phoenix, AZ 85014-2446
Phone
(602) 274-7840
Fax
(602) 274-7956
NPI assigned
Mar 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2814 AZ Primary

Addresses

Primary practice location

1515 E Missouri Ave
Suite 101
Phoenix, AZ 85014-2446

Mailing address

1515 E Missouri Ave
Suite 101
Phoenix, AZ 85014-2446
Phone (602) 274-7840

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070209000570 AZ Practitioner - Maxillofacial Surgery 9032111687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Univ of Calif, San Francisco School of Dentistry, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1515 E Missouri Ave
Suite 101
Phoenix, AZ 85014-2443
Phone (602) 274-7840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serrano Chandler LLC Orthodontics and Dentofacial Orthopedics CurrentSince Mar 13, 2018 Accepting new patients
San Marcos Orthodontics PLLC Orthodontics and Dentofacial Orthopedics PastSince Jul 15, 2010 Accepting new patients
Castle Pines Sleep Solutions LLC PastSince Jun 6, 2011 Accepting new patients

Locations

800 W Chandler Blvd
Ste 5
Chandler, AZ 85225
Phone (480) 899-1633

Organizations & group practices 4

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": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1366783060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E MISSOURI AVE",
            "address_2": "SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142446",
            "telephone_number": "602-274-7840",
            "fax_number": "602-274-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E MISSOURI AVE",
            "address_2": "SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142446",
            "telephone_number": "602-274-7840",
            "fax_number": "602-274-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "ALBERT",
        "middle_name": "P",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "2814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.