Gary Wayne Edgar, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AZ2261 Issued in AZ

Practice address

1989 Frontage Rd
Sierra Vista, AZ 85635-4698

Phone

(858) 547-2564

Fax

(858) 547-2764

NPI assigned

Dec 18, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720141070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 FRONTAGE RD",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354698",
            "telephone_number": "858-547-2564",
            "fax_number": "858-547-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 FRONTAGE RD",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354698",
            "telephone_number": "858-547-2564",
            "fax_number": "858-547-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGAR",
        "first_name": "GARY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ2261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Z Eaton, LCSW
• Kimberly Ann Eckley, WHC NP RNC
• Eden Home Health of Sierra Vista, LLC
• Eden Hospice at Cochise County, LLC
• Laramie Jo Edens, DMD
• Eduardo Montes DPM PLLC
• Ramsey G Edwards, DMD
• Hannah Egbert
• Faith Megan Eidson, MSW
• Njideka Augustina Ekwelundu, RPH.

• General Practice Dentistry in Sierra Vista, AZ
• Providers in Sierra Vista, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.