Randy R. Fitzgerald, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6988 Issued in AZ

Practice address

4350 E Ray Rd
Building 2 Suite 110
Phoenix, AZ 85044-4703

Phone

(480) 706-0777

Fax

(480) 706-0825

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Yes, effective Mar 16, 2017 through Mar 16, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Az Perio PLLC

  dba Paradise Valley Periodontics

  • Periodontics
  • Scottsdale, AZ
  • NPI 1437222809
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669549119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "address_2": "BUILDING 2 SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-706-0777",
            "fax_number": "480-706-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "address_2": "BUILDING 2 SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-706-0777",
            "fax_number": "480-706-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "RANDY",
        "middle_name": "R.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "6988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geraldine Ann Fitzgerald, RN
• Jason Fitzgerald
• Jo Ellen Fitzgerald
• John Fitzgerald, M.D.
• Michele Marie Fitzgerald, RN
• Molly Fitzgibbons, FNP-C
• Peter Fitzgibbons, MD
• Blythe A Fitzharris, PH.D., LCSW
• Grace Lauren Fitzpatrick
• Jennifer Fitzpatrick, DVM

• Periodontics in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Periodontics in Arizona

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.