Active NPI
Bridget Raquel Swanberg-Austin, D.D.S.
- General Practice Dentistry
- San Carlos, AZ
National Provider Identifier
1518076595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-024374
- Practice address
- 223 Cibeque Circle Road
San Carlos, AZ 85550 - Phone
- (928) 475-7354
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019-024374 | IL | Primary |
Addresses
Primary practice location
223 Cibeque Circle Road
San Carlos, AZ 85550
Mailing address
PO Box 208
San Carlos, AZ 85550-0208
Phone (928) 475-7354
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 524571 | Medicaid | AZ |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-024374 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1518076595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 208",
"city": "SAN CARLOS",
"state": "AZ",
"postal_code": "855500208",
"telephone_number": "928-475-7354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 CIBEQUE CIRCLE ROAD",
"city": "SAN CARLOS",
"state": "AZ",
"postal_code": "85550",
"telephone_number": "928-475-7354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANBERG-AUSTIN",
"first_name": "BRIDGET",
"middle_name": "RAQUEL",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-024374",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "524571",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.