Individual provider Active NPI

Dominic Cheng-Wei Tam, DMD

  • Dentist
  • Queen Creek, AZ
National Provider Identifier
1477700250
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
008315 Issued in AZ
Practice address
35 W Combs Rd Ste 102
Queen Creek, AZ 85140-9102
Phone
(480) 677-8580
NPI assigned
Aug 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 008315 AZ Primary

Addresses

Primary practice location

35 W Combs Rd Ste 102
Queen Creek, AZ 85140-9102

Mailing address

857 E Libra PL
Chandler, AZ 85249-3642
Phone (510) 432-5491

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

Practice roles

OrganizationSpecialtyStatusNew patients
Specialists Dental Implant Center Past Accepting new patients
New Image Dentistry PLLC Past Accepting new patients
DF Dental PLLC General Practice PastSince Jul 25, 2021 Accepting new patients
New Imageorthodontics LLC Past Accepting new patients

Organizations & group practices 4

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1477700250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 E LIBRA PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493642",
            "telephone_number": "510-432-5491",
            "fax_number": "480-831-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W COMBS RD STE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851409102",
            "telephone_number": "480-677-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "DOMINIC",
        "middle_name": "CHENG-WEI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "008315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.