Individual provider Active NPI

Maritza Sanchez-Salazar

  • General Practice Dentistry
  • Chino Valley, AZ
National Provider Identifier
1396740155
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4972 Issued in AZ
Practice address
1578 N Hwy 89 Ste 1
Chino Valley, AZ 86323-7624
Phone
(928) 237-4061
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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 4972 AZ Primary

Addresses

Primary practice location

1578 N Hwy 89 Ste 1
Chino Valley, AZ 86323-7624

Mailing address

1578 N Hwy 89 Ste 1
Chino Valley, AZ 86323-7624
Phone (928) 237-4061

Other identifiers 1

IdentifierTypeStateIssuer
444951MedicaidAZ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718003767 AZ Order and Referring Only - DentistPractitioner - Dentist 4981974334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4972AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Maritza Sanchez-Salazar DDS, PLC CurrentSince Sep 20, 2020 Accepting new patients

Locations

1578 N Highway 89
Ste 1
Chino Valley, AZ 86323
Phone (928) 300-8100

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1396740155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1578 N HWY 89 STE 1",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863237624",
            "telephone_number": "928-237-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1578 N HWY 89 STE 1",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863237624",
            "telephone_number": "928-237-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ-SALAZAR",
        "first_name": "MARITZA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444951",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Valley, AZ

Sources for this page

Verify at the official NPI Registry.