Active NPI
Brett David Flaherty, DMD
- Dentist
- Payson, AZ
National Provider Identifier
1407143456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D008246
- Practice address
- 712 N Beeline Hwy
Payson, AZ 85541-3706 - Phone
- (928) 474-4581
- Fax
- (928) 474-4585
- NPI assigned
- Jun 28, 2011
- Last updated
- Jun 28, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | D008246 | AZ | Primary |
Addresses
Primary practice location
712 N Beeline Hwy
Payson, AZ 85541-3706
Mailing address
712 N Beeline Hwy
Payson, AZ 85541-3706
Phone (928) 474-4581
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
| License | State | Type | Specialty |
|---|---|---|---|
| D008246 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona State Public Health Laboratory | Past | Accepting new patients | |
| Arizona Department of Health Services | 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.
-
- Public Health Dentistry
- Phoenix, AZ
- NPI 1538593157
-
dba ADHS Newborn Screening Program
- Clinical Medical Laboratory
- Phoenix, AZ
- NPI 1528180874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1407143456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 N BEELINE HWY",
"city": "PAYSON",
"state": "AZ",
"postal_code": "855413706",
"telephone_number": "928-474-4581",
"fax_number": "928-474-4585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 N BEELINE HWY",
"city": "PAYSON",
"state": "AZ",
"postal_code": "855413706",
"telephone_number": "928-474-4581",
"fax_number": "928-474-4585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAHERTY",
"first_name": "BRETT",
"middle_name": "DAVID",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D008246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Payson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.