Individual provider Active NPI

James Richard Michaud, DDS MS

  • Pediatric Dentistry
  • Gilbert, AZ
National Provider Identifier
1770706806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D3689 Issued in AZ
Practice address
2363 E Baseline Rd
Gilbert, AZ 85234-2357
Phone
(480) 558-1400
NPI assigned
Apr 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Pediatric Dentistry 1223P0221X D3689 AZ Primary

Addresses

Primary practice location

2363 E Baseline Rd
Gilbert, AZ 85234-2357

Mailing address

2363 E Baseline Rd
Gilbert, AZ 85234-2357

Other identifiers 1

IdentifierTypeStateIssuer
000579846OtherUNITED CONCORDIA ID

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D3689AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Dentistry for Children LLC Pediatric Dentistry Past Accepting new patients

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770706806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2363 E BASELINE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2363 E BASELINE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342357",
            "telephone_number": "480-558-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "JAMES",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D3689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID",
            "identifier": "000579846",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • 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.