Individual provider Active NPI

Gwenlynn Laine Multine, DMD

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1700033784
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7587 Issued in AZ
Practice address
301 E Bethany Home Rd Ste C194
Phoenix, AZ 85012-1266
Phone
(602) 277-9088
NPI assigned
Aug 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7587 AZ Primary
Dentist 122300000X DB-2025-0249 NM

Addresses

Primary practice location

301 E Bethany Home Rd Ste C194
Phoenix, AZ 85012-1266

Mailing address

301 E Bethany Home Rd Ste C194
Phoenix, AZ 85012-1266
Phone (602) 277-9088

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
I20161025001552 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971796285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7587AZMDDentist
DB-2025-0249NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Dental PLLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

301 E Bethany Home Rd
Ste C194
Phoenix, AZ 85012
Phone (602) 277-9088

Organizations & group practices 1

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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1700033784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E BETHANY HOME RD STE C194",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121266",
            "telephone_number": "602-277-9088",
            "fax_number": "602-277-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E BETHANY HOME RD STE C194",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121266",
            "telephone_number": "602-277-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULTINE",
        "first_name": "GWENLYNN",
        "middle_name": "LAINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7587",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DB-2025-0249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.