Individual provider Active NPI

Cory Wertz, DDS

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1437243169
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5200 Issued in AZ
Practice address
1500 W Commerce CT BLDG C
Tucson, AZ 85746-6031
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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 5200 AZ Primary

Addresses

Primary practice location

1500 W Commerce CT BLDG C
Tucson, AZ 85746-6031

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Other identifiers 1

IdentifierTypeStateIssuer
646747MedicaidAZ

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
I20150915002714 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880744820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5200AZMDPediatric Adolescent Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1437243169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W COMMERCE CT BLDG C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466031",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTZ",
        "first_name": "CORY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "646747",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.