Individual provider Active NPI

Elliot Saperstein, D.M.D., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Glendale, AZ
National Provider Identifier
1780002964
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D009844 Issued in AZ
Practice address
5750 W Thunderbird Rd Ste H800
Glendale, AZ 85306-4675
Phone
(602) 978-2100
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D009844 AZ Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN.00202669 CO

Addresses

Primary practice location

5750 W Thunderbird Rd Ste H800
Glendale, AZ 85306-4675

Mailing address

5750 W Thunderbird Rd Ste H800
Glendale, AZ 85306-4675

Other practice location 1

16611 S 40th St Ste 110
Phoenix, AZ 85048-0563
Phone (602) 978-2100

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
D009844AZMDOrthodontics and Dentofacial Orthopedic Dentist
DEN.00202669COMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Orthodontists LTD Orthodontics and Dentofacial Orthopedics PastSince Jul 10, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1780002964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD STE H800",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD STE H800",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064675",
            "telephone_number": "602-978-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16611 S 40th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850480563",
            "country_code": "US",
            "telephone_number": "602-978-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAPERSTEIN",
        "first_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D009844",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "DEN.00202669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; 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.