Individual provider Active NPI

Ashley Madern, D.M.D.

  • Oral and Maxillofacial Radiology Dentistry
  • Glendale, AZ
National Provider Identifier
1649727322
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
D011491 Issued in AZ
Practice address
5855 W Utopia Rd
Glendale, AZ 85308-5251
Phone
(623) 806-7000
Fax
(623) 806-7010
NPI assigned
Sep 9, 2016
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10496 NC
Oral and Maxillofacial Radiology Dentistry 1223X0008X D011491 AZ Primary

Addresses

Primary practice location

5855 W Utopia Rd
Glendale, AZ 85308-5251

Mailing address

1608 W White Feather LN
Phoenix, AZ 85085-5341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 10, 2022 through Aug 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D011491AZMDOral and Maxillofacial Radiology Dentist
10496NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University CurrentSince Sep 29, 2024 Accepting new patients

Locations

5855 W Utopia Rd
Glendale, AZ 85308
Phone (623) 806-7000

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, 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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1649727322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 W WHITE FEATHER LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850855341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-806-7000",
            "fax_number": "623-806-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADERN",
        "first_name": "ASHLEY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10496",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "AZ",
            "license": "D011491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.