NPIMap

Organization Active NPI

TMJ of Arizona LLC

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1376815779
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2928 Issued in AZ
Legal business name
TMJ OF ARIZONA LLC
Practice address
13821 N 35TH Dr
Ste 1
Phoenix, AZ 85053-5541
Phone
(602) 866-1429
Fax
(602) 866-1437
NPI assigned
Jan 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Authorized official

Name
Gary J Core, DDSNPI 1215156799
Title
Member
Phone
(602) 866-1429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2928 AZ Primary

Addresses

Primary practice location

13821 N 35TH Dr
Ste 1
Phoenix, AZ 85053-5541

Mailing address

13821 N 35TH Dr
Ste 1
Phoenix, AZ 85053-5541
Phone (602) 866-1429

Other names 1

  • Core Sleep Solutions Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120430000271 AZ Part B Supplier - Clinic/Group Practice 8325200827 Receives reassigned benefits from 2 practitioners
Practice locations: Phoenix, AZ; Tempe, AZ
O20120621000401 AZ DME Supplier - Oral Surgery - Dentist 8325200827 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tempe, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1376815779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13821 N 35TH DR",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850535541",
            "telephone_number": "602-866-1429",
            "fax_number": "602-866-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13821 N 35TH DR",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850535541",
            "telephone_number": "602-866-1429",
            "fax_number": "602-866-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMJ OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "CORE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-866-1429",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Core Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.