Laramie Jo Edens, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012166 Issued in AZ

Practice address

115 Calle Portal
Sierra Vista, AZ 85635-2950

Phone

(520) 459-3011

Fax

(520) 417-4481

NPI assigned

Jun 12, 2024

Last updated

Jun 12, 2024By the provider in NPPES

Sex

Female

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 TX

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

Practice roles

Locations

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.

• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Gila River Health Care

  dba Thwajik Ke Outpatient Behavioral Health Services

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  dba Red Tail Hawk BHS-CM

  • Case Management Agency
  • Chandler, AZ
  • NPI 1629579230
  NPD
• Chiricahua Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sierra Vista, AZ
  • NPI 1629499397
  NPD (past)

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1538901152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-1429",
            "fax_number": "520-515-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CALLE PORTAL",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352950",
            "telephone_number": "520-459-3011",
            "fax_number": "520-417-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENS",
        "first_name": "LARAMIE",
        "middle_name": "JO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Chanell Eaton, RN
• Gail Z Eaton, LCSW
• Kimberly Ann Eckley, WHC NP RNC
• Eden Home Health of Sierra Vista, LLC (Eden Home Health)
• Eden Hospice at Cochise County, LLC (Eden Hospice)
• Gary Wayne Edgar, D.D.S.
• Eduardo Montes DPM PLLC
• Ramsey G Edwards, DMD
• Hannah Egbert
• Faith Megan Eidson, MSW

• General Practice Dentistry in Sierra Vista, AZ
• Providers in Sierra Vista, 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 Jun 12, 2024; 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.