Individual provider Active NPI

Jelena Lamacchia, DDS

  • General Practice Dentistry
  • Scottsdale, AZ
National Provider Identifier
1619406857
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D009770 Issued in AZ
Practice address
8438 E Shea Blvd Ste 100
Scottsdale, AZ 85260-6669
Phone
(480) 661-7745
NPI assigned
Jun 10, 2017
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 009770 AZ
General Practice Dentistry 1223G0001X D009770 AZ Primary

Addresses

Primary practice location

8438 E Shea Blvd Ste 100
Scottsdale, AZ 85260-6669

Mailing address

23963 N 77TH Way
Scottsdale, AZ 85255-6153
Phone (262) 960-2783

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
D009770AZMDGeneral Practice Dentistry
009770AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burke D Frei DDS PLLC General Practice PastSince Jun 18, 2023 Accepting new patients
Rosenthal Chiang Dentistry, P.L.C. General Practice PastSince Jun 18, 2023 Accepting new patients
Southern Square Dentistry PLC General Practice Past Accepting new patients
Central Valley Dental Care LLC PastSince Aug 2, 2020 Accepting new patients

Organizations & group practices 4

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": "1497052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1619406857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23963 N 77TH WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852556153",
            "telephone_number": "262-960-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8438 E SHEA BLVD STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606669",
            "telephone_number": "480-661-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMACCHIA",
        "first_name": "JELENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-10",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "009770",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.