Individual provider Active NPI

Bethany Helen Armendariz, DMD

  • General Practice Dentistry
  • Glendale, AZ
National Provider Identifier
1376101188
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D010639 Issued in AZ
Practice address
18555 N 79TH Ave Ste B104
Glendale, AZ 85308-8372
Phone
(623) 334-2400
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 103741 CA
General Practice Dentistry 1223G0001X D010639 AZ Primary

Addresses

Primary practice location

18555 N 79TH Ave Ste B104
Glendale, AZ 85308-8372

Mailing address

7579 W Marconi Ave
Peoria, AZ 85382-1505
Phone (760) 791-0731

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
D010639AZMDGeneral Practice Dentistry
103741CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany H Armendariz DMD PLLC CurrentSince Jun 23, 2024 Accepting new patients
Dentists of Paradise Valley, LLP PastSince Nov 1, 2020 Accepting new patients
Glendale Modern Dentistry, LLP PastSince Jan 1, 2021 Accepting new patients
Kazarian, Khachatryan, Azatyan, a Professional Dental Corporation PastSince Jun 21, 2022 Accepting new patients

Locations

18555 N 79th Ave
Ste B104
Glendale, AZ 85308
Phone (623) 334-2400

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1376101188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7579 W MARCONI AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853821505",
            "telephone_number": "760-791-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE B104",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088372",
            "telephone_number": "623-334-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMENDARIZ",
        "first_name": "BETHANY",
        "middle_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-06-17",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103741",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.