Stephen McComas, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010849 Issued in AZ

Practice address

13410 E Mary Ann Cleveland Way
Vail, AZ 85641-8613

Phone

(520) 316-0613

NPI assigned

Aug 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Dentists of Vail, LLP

  dba Dentists of Vail

  • Dentist
  • Vail, AZ
  • NPI 1457814063
  NPD (past)

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1558974121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7307 E HEARTWOOD DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857566138",
            "telephone_number": "575-649-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13410 E MARY ANN CLEVELAND WAY",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856418613",
            "telephone_number": "520-316-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMAS",
        "first_name": "STEPHEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BOARD OF DENTAL EXAMINERS",
            "identifier": "D010849",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marin
• Joann M Marino, PHARMD
• Jennifer Marseglia, COTA/L
• Theresa Maria Martinez, B.S.; M.S.
• Candice Mason, BS
• Brienne Elizabeth McCreery, MS, CCC-SLP
• Jada Nicole McGlothin, DOCTOR OF EDUCATION
• Laurie Anne McMahon, FNP-C
• Rita Lorraine Mellon, RN
• Jason Daniel Miller

• General Practice Dentistry in Vail, AZ
• Providers in Vail, 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 Aug 25, 2020; 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.