Individual provider Active NPI

Daniel Schmid, D.M.D.

  • Dentist
  • Peoria, AZ
National Provider Identifier
1487054896
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8958 Issued in AZ
Practice address
13470 N 83Rd Ave
Suite 200
Peoria, AZ 85381-4623
Phone
(623) 776-1376
Fax
(623) 487-5037
NPI assigned
Sep 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8958 AZ Primary

Addresses

Primary practice location

13470 N 83Rd Ave
Suite 200
Peoria, AZ 85381-4623

Mailing address

13470 N 83Rd Ave
Suite 200
Peoria, AZ 85381-4623
Phone (623) 776-1376

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
I20170110000559 AZ Order and Referring Only - DentistPractitioner - Dentist 7113208943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8958AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Schmid Family Dentistry CurrentSince Apr 24, 2022 Accepting new patients
Sundance Dental Group, LLP General Practice PastSince Feb 9, 2020 Accepting new patients

Locations

13470 N 83rd Ave
Ste 200
Peoria, AZ 85381
Phone (623) 776-1376

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1487054896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13470 N 83RD AVE",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814623",
            "telephone_number": "623-776-1376",
            "fax_number": "623-487-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13470 N 83RD AVE",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814623",
            "telephone_number": "623-776-1376",
            "fax_number": "623-487-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMID",
        "first_name": "DANIEL",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.