Individual provider Active NPI

John K Swain, DMD

  • Dentist
  • Gilbert, AZ
National Provider Identifier
1568651685
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5267 Issued in AZ
Practice address
1661 S Val Vista Dr
Suite # C-101
Gilbert, AZ 85295-4508
Phone
(480) 558-3100
Fax
(480) 855-9507
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5267 AZ Primary

Addresses

Primary practice location

1661 S Val Vista Dr
Suite # C-101
Gilbert, AZ 85295-4508

Mailing address

1661 S Val Vista Dr
Suite # C-101
Gilbert, AZ 85295-4508
Phone (480) 558-3100

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
5267AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1568651685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 S VAL VISTA DR",
            "address_2": "SUITE # C-101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954508",
            "telephone_number": "480-558-3100",
            "fax_number": "480-855-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 S VAL VISTA DR",
            "address_2": "SUITE # C-101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954508",
            "telephone_number": "480-558-3100",
            "fax_number": "480-855-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.