Stacy Tracy, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4478 Issued in AZ

Practice address

1712 E Guadalupe Rd
Suite 109
Tempe, AZ 85283-3983

Phone

(480) 829-8200

Fax

(480) 967-5252

NPI assigned

Apr 27, 2006

Sex

Female

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

Enrolled in AZ

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mill Avenue Family Dentistry PC

  • General Practice Dentistry
  • Tempe, AZ
  • NPI 1245309640
  NPD (past) Authorized official

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1689631160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 E GUADALUPE RD",
            "address_2": "SUITE 109",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833983",
            "telephone_number": "480-829-8200",
            "fax_number": "480-967-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 E GUADALUPE RD",
            "address_2": "SUITE 109",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833983",
            "telephone_number": "480-829-8200",
            "fax_number": "480-967-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Townes
• Lisa Townsend, PTA
• Tracey Bryce MD PC
• Alyson Noelle Tracy, LAC
• Ann M Tracy, A.P.R.N
• Lauren Michelle Trader, M.S. CCC-SLP
• Sarah Trahan, NMD
• James Allen Train Or
• Hy K Tran, RDH
• Tiffany Trinh Tran

• General Practice Dentistry in Tempe, AZ
• Providers in Tempe, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.

Verify at the official NPI Registry.