Individual provider Active NPI

Brian Callaway, DDS

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1669874129
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011715 Issued in AZ
Practice address
6500 N Scottsdale Rd Ste B200
Scottsdale, AZ 85253-4431
Phone
(480) 946-6503
NPI assigned
Sep 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D011715 AZ Primary
Dentist 122300000X D008986 AZ

Addresses

Primary practice location

6500 N Scottsdale Rd Ste B200
Scottsdale, AZ 85253-4431

Mailing address

6500 N Scottsdale Rd Ste B200
Scottsdale, AZ 85253-4431
Phone (480) 946-6503

Other practice location 1

6626 E Baseline Rd
Suite 101
Mesa, AZ 85206-4422
Phone (480) 218-8800

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
D008986AZMDDentist
D011715AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1669874129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 N SCOTTSDALE RD STE B200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852534431",
            "telephone_number": "480-946-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 N SCOTTSDALE RD STE B200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852534431",
            "telephone_number": "480-946-6503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6626 E Baseline Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852064422",
            "country_code": "US",
            "telephone_number": "480-218-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "BRIAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011715",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D008986",
            "primary": false
        }
    ],
    "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 Sep 18, 2024; 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.