Active NPI
Michael Lant Pace, DMD
- Student in an Organized Health Care Education/Training Program
- Mesa, AZ
National Provider Identifier
1679321525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5835 E Still Cir
Mesa, AZ 85206-3618 - Phone
- (480) 248-8100
- NPI assigned
- May 7, 2024
- Last updated
- Jun 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5835 E Still Cir
Mesa, AZ 85206-3618
Mailing address
18830 N 34TH LN Unit 4
Phoenix, AZ 85027-6177
Phone (623) 227-0925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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 |
|---|---|---|---|---|
| I20250519003085 | IN | Order and Referring Only - Prosthodontics | 4385162734 |
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": "1715040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1679321525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18830 N 34TH LN UNIT 4",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850276177",
"telephone_number": "623-227-0925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5835 E STILL CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852063618",
"telephone_number": "480-248-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACE",
"first_name": "MICHAEL",
"middle_name": "LANT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-07",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Jun 3, 2024; 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.