Active NPI
Brian T. Mazel
- General Practice Dentistry
- Glendale, AZ
National Provider Identifier
1679003172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D009761
- Practice address
- 6615 W Happy Valley Rd # 103
Glendale, AZ 85310-2608 - Phone
- (623) 300-2920
- NPI assigned
- Jun 15, 2017
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D009761 | AZ | Primary |
Addresses
Primary practice location
6615 W Happy Valley Rd # 103
Glendale, AZ 85310-2608
Mailing address
12998 E Corrine Dr
Scottsdale, AZ 85259-3554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102001771 | AZ | Order and Referring Only - Dentist | 6103182456 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497484800000",
"number": "1679003172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12998 E CORRINE DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852593554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6615 W HAPPY VALLEY RD # 103",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853102608",
"telephone_number": "623-300-2920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZEL",
"first_name": "BRIAN",
"middle_name": "T.",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-15",
"last_updated": "2017-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D009761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.