Active NPI
Nathan Ray Porter, D.D.S.
- General Practice Dentistry
- Mesa, AZ
National Provider Identifier
1710140686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7582
- Practice address
- 855 E Brown Rd
Suite 4
Mesa, AZ 85203-4958 - Phone
- (480) 834-6100
- NPI assigned
- Jul 9, 2008
- Last updated
- Apr 19, 2012
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7582 | AZ | Primary |
Addresses
Primary practice location
855 E Brown Rd
Suite 4
Mesa, AZ 85203-4958
Mailing address
855 E Brown Rd
Suite 4
Mesa, AZ 85203-4958
Phone (480) 834-6100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334793600000",
"number": "1710140686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 E BROWN RD",
"address_2": "SUITE 4",
"city": "MESA",
"state": "AZ",
"postal_code": "852034958",
"telephone_number": "480-834-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 E BROWN RD",
"address_2": "SUITE 4",
"city": "MESA",
"state": "AZ",
"postal_code": "852034958",
"telephone_number": "480-834-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "NATHAN",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2012-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "7582",
"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 Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.