Individual provider Active NPI

Tzvetelina Mladenova, D.M.D.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1396820205
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5964 Issued in AZ
Practice address
1043 E. Missouri Ave
Phoenix, AZ 85014
Phone
(602) 216-0100
Fax
(602) 216-0200
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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 5964 AZ Primary

Addresses

Primary practice location

1043 E. Missouri Ave
Phoenix, AZ 85014

Mailing address

1043 E. Missouri Ave.
Phoenix, AZ 85014
Phone (602) 216-0100

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
I20161018001265 AZ Order and Referring Only - DentistPractitioner - Dentist 2668760026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5964AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
LZM DDS & Associates PC General Practice Past Accepting new patients
Silvertree Dentistry Past Accepting new patients

Organizations & group practices 2

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1396820205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 E. MISSOURI AVE.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85014",
            "telephone_number": "602-216-0100",
            "fax_number": "602-216-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 E. MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85014",
            "telephone_number": "602-216-0100",
            "fax_number": "602-216-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLADENOVA",
        "first_name": "TZVETELINA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.