Individual provider Active NPI

Allistair Campbell Ray, D.D.S.

  • Dentist
  • Gilbert, AZ
National Provider Identifier
1689703316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5850 Issued in AZ
Practice address
1111 N Gilbert Rd Ste. 117
Gilbert, AZ 85234-0000
Phone
(480) 539-7222
Fax
(480) 539-2998
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D5850 AZ Primary

Addresses

Primary practice location

1111 N Gilbert Rd Ste. 117
Gilbert, AZ 85234-0000

Mailing address

10227 E Los Lagos Vista Ave
Mesa, AZ 85209-1229
Phone (480) 357-2097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20170411000571 TX Practitioner - Oral Surgery 3375768617 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5850AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Feb 11, 2017 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

Dept LA 23811
Pasadena, CA 91185

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689703316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10227 E LOS LAGOS VISTA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091229",
            "telephone_number": "480-357-2097",
            "fax_number": "480-539-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N GILBERT RD STE. 117",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852340000",
            "telephone_number": "480-539-7222",
            "fax_number": "480-539-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ALLISTAIR",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.