Individual provider Active NPI

Roger Dulvick, DDS

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1689713869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AZ4225 Issued in AZ
Practice address
4125 W Chandler Blvd
Chandler, AZ 85226-3709
Phone
(480) 961-7400
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X AZ4225 AZ Primary

Addresses

Primary practice location

4125 W Chandler Blvd
Chandler, AZ 85226-3709

Mailing address

4125 W Chandler Blvd
Chandler, AZ 85226-3709

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302000217 AZ Order and Referring Only - DentistPractitioner - Dentist 8820393796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ4225AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Saldua Dental Collective PLLC Past Accepting new patients
Roger J Dulvick DDS PC General Practice Past Accepting new patients

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689713869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 W CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 W CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263709",
            "telephone_number": "480-961-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULVICK",
        "first_name": "ROGER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ4225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.