Individual provider Active NPI

John Davidson Doerr, DDS

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1487664462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2073 Issued in AZ
Practice address
5255 E Knight Dr
Tucson, AZ 85712-2147
Phone
(520) 881-6767
Fax
(520) 881-3759
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2073 AZ Primary

Addresses

Primary practice location

5255 E Knight Dr
Tucson, AZ 85712-2147

Mailing address

5255 E Knight Dr
Tucson, AZ 85712-2147
Phone (520) 881-6767

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

State licenses

LicenseStateTypeSpecialty
2073AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
BG Dental Incorporated PastSince Jul 21, 2017 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487664462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 E KNIGHT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122147",
            "telephone_number": "520-881-6767",
            "fax_number": "520-881-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 E KNIGHT DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122147",
            "telephone_number": "520-881-6767",
            "fax_number": "520-881-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERR",
        "first_name": "JOHN",
        "middle_name": "DAVIDSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.