Active NPI
Elwynn Chad Caffall, D.D.S
- Dentist
- Mesa, AZ
National Provider Identifier
1639370745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- AZD6591
- Practice address
- 1801 E Southern Ave
Suite 101
Mesa, AZ 85204-5258 - Phone
- (480) 892-0060
- Fax
- (480) 892-8806
- NPI assigned
- May 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | AZD6591 | AZ | Primary |
Addresses
Primary practice location
1801 E Southern Ave
Suite 101
Mesa, AZ 85204-5258
Mailing address
1801 E Southern Ave
Suite 101
Mesa, AZ 85204-5258
Phone (480) 892-0060
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
| License | State | Type | Specialty |
|---|---|---|---|
| AZD6591 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WPF Holdings LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639370745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 E SOUTHERN AVE",
"address_2": "SUITE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852045258",
"telephone_number": "480-892-0060",
"fax_number": "480-892-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 E SOUTHERN AVE",
"address_2": "SUITE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852045258",
"telephone_number": "480-892-0060",
"fax_number": "480-892-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAFFALL",
"first_name": "ELWYNN",
"middle_name": "CHAD",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "AZD6591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.