Active NPI
Kristen M Mayorga, DDS
- Dentist
- Phoenix, AZ
National Provider Identifier
1396973327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7792
- Practice address
- 6231 S Central Ave
Phoenix, AZ 85042-4236 - Phone
- (602) 268-2273
- NPI assigned
- Jun 29, 2009
- Last updated
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7792 | AZ | Primary |
Addresses
Primary practice location
6231 S Central Ave
Phoenix, AZ 85042-4236
Mailing address
6231 S Central Ave
Phoenix, AZ 85042-4236
Phone (602) 268-2273
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150609000225 | AZ | Order and Referring Only - General Practice | 4284955808 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7792 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kristen M Mayorga PLLC | Current | Accepting new patients | |
| Desert Dentistry, PLLC | Dentist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246233600000",
"number": "1396973327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6231 S CENTRAL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850424236",
"telephone_number": "602-268-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6231 S CENTRAL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850424236",
"telephone_number": "602-268-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYORGA",
"first_name": "KRISTEN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2009-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D7792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
- Mayo Clinic Arizona (Mayo Clinic Phoenix Oncology Pharmacy)
- Mayo Clinic Arizona (Mayo Clinic Specialty Building)
- Mayo Clinic Arizona
- Mayo Clinic Arizona (Mayo Clinic Hospital Out Patient Pharmacy)
- Mayo Foundation for Medical Education & Research (Mayo Clinic Store - Flower of Hope)
- Roger M Mayorga, APN
- Julie Annette Mays, PA
- Kalinea K Mays, LMSW
- Megan Victoria Mays
- Racha Mayta
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.