Individual provider Active NPI

Beth Hamann, D.D.S.

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1609875020
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D3874 Issued in AZ
Practice address
4235 N 32ND St
Suite C
Phoenix, AZ 85018-4766
Phone
(602) 957-2411
NPI assigned
Jul 18, 2005
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D3874 AZ Primary

Addresses

Primary practice location

4235 N 32ND St
Suite C
Phoenix, AZ 85018-4766

Mailing address

4235 N 32ND St
Suite C
Phoenix, AZ 85018-4766
Phone (602) 957-2411

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150520000146 AZ Practitioner - Oral Surgery 2567782626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Loma Linda University School of Dentistry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austrocylindropuntia LLCGroup PAC ID 1759601818, 2 clinicians

Practice addresses (Care Compare)

4235 N 32ND St
Suite a
Phoenix, AZ 85018-4766
Phone (602) 957-3808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D3874AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Austrocylindropuntia, LLC General Practice CurrentSince Apr 20, 2015 Accepting new patients
Austrocylindropuntia, LLC Dentist Current Accepting new patients
Agave Dental LLC General Practice Past Accepting new patients

Locations

4235 N 32nd St
Ste A
Phoenix, AZ 85018
Phone (602) 957-3808

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1609875020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 N 32ND ST",
            "address_2": "SUITE C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850184766",
            "telephone_number": "602-957-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 N 32ND ST",
            "address_2": "SUITE C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850184766",
            "telephone_number": "602-957-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMANN",
        "first_name": "BETH",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D3874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.