Dean Soupal, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT-28698 Issued in AZ

Practice address

2155 W State Route 89a Ste 114
Sedona, AZ 86336-5445

Phone

(928) 239-9706

Fax

(928) 239-9716

NPI assigned

May 31, 2023

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

Credentials

Medical Technician

State licenses

Practice roles

Locations

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.

• Amazing Acupuncture & Asian Medicine, PLLC

  • Acupuncturist
  • Sedona, AZ
  • NPI 1124722251
  NPD

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1750074142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 JUNIPER TRL",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863366503",
            "telephone_number": "248-495-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W STATE ROUTE 89A STE 114",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365445",
            "telephone_number": "928-239-9706",
            "fax_number": "928-239-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUPAL",
        "first_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-28698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Sedona, AZ
• Providers in Sedona, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.