Individual provider Active NPI

Jon M. Delsnyder, DDS, MS

  • Dentist
  • Tempe, AZ
National Provider Identifier
1528061421
Registry record updated Sep 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7114 Issued in AZ
Practice address
6655 S Rural Rd Ste 1
Tempe, AZ 85283-3793
Phone
(602) 346-9775
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X D7114 AZ
Dentist 122300000X D7114 AZ Primary

Addresses

Primary practice location

6655 S Rural Rd Ste 1
Tempe, AZ 85283-3793

Mailing address

6655 S Rural Rd Ste 1
Tempe, AZ 85283-3793
Phone (602) 346-9775

Other practice location 1

995 E Baseline Rd Apt 1172
Tempe, AZ 85283-1354
Phone (480) 559-1958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170106000611 WA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2264713270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D7114AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1528061421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 S RURAL RD STE 1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833793",
            "telephone_number": "602-346-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 S RURAL RD STE 1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833793",
            "telephone_number": "602-346-9775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "995 E Baseline Rd Apt 1172",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852831354",
            "country_code": "US",
            "telephone_number": "480-559-1958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELSNYDER",
        "first_name": "JON",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "AZ",
            "license": "D7114",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.