Derek Snare, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009900 Issued in AZ

Practice address

4175 S Alamo Ave BLDG 400
Davis Monthan Afb, AZ 85707-4402

Phone

(520) 228-1559

NPI assigned

Feb 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1477893485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE BLDG 400",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE BLDG 400",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074402",
            "telephone_number": "520-228-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNARE",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-28",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine B. O'Neal, CADC
• Sarah J Ostrom, PA-C
• Isabella Ruiz, PHARMD, RPH
• Esmat Marie Sabbagh, IDMT
• Jennifer Saulnier, MD
• Michael Stoddard
• Andrew Joseph Stoy, D.D.S. , M.S.
• Sarah Elizabeth Szybist, DO
• Natalie Tobar
• Virginia Ann Underwood, M.D.

• General Practice Dentistry in Davis Monthan Afb, AZ
• Providers in Davis Monthan Afb, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.

Verify at the official NPI Registry.