Individual provider Active NPI

Robert G Cox, DDS

  • Pediatric Dentistry
  • Glendale, AZ
National Provider Identifier
1407389869
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D010268 Issued in AZ
Practice address
5940 W Union Hills Dr Ste B190
Glendale, AZ 85308-1359
Phone
(602) 314-4600
NPI assigned
Apr 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X D010268 AZ Primary

Addresses

Primary practice location

5940 W Union Hills Dr Ste B190
Glendale, AZ 85308-1359

Mailing address

15225 N 20TH St
Phoenix, AZ 85022-4053
Phone (810) 280-7112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190129000200 NY Order and Referring Only - DentistPractitioner - Dentist 3173860293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D010268AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Ridge Pediatric Dentistry Past Accepting new patients
Shine Az LLC PastSince Sep 5, 2021 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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1407389869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 N 20TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224053",
            "telephone_number": "810-280-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 W UNION HILLS DR STE B190",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081359",
            "telephone_number": "602-314-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COX",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D010268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.