Active NPI
Edward Scott Connell, DMD
- General Practice Dentistry
- Tempe, AZ
National Provider Identifier
1831262278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D6107
- Practice address
- 2010 E Elliot Rd Ste 105
Tempe, AZ 85284 - Phone
- (480) 899-7996
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
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 | D6107 | AZ | Primary |
Addresses
Primary practice location
2010 E Elliot Rd Ste 105
Tempe, AZ 85284
Mailing address
1677 East Florence Blvd
Suite 24
Casa Grande, AZ 85222
Phone (520) 836-5466
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6107 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impressions at Casa Grande PLC | Past | Accepting new patients | |
| Arizona Dental Pavillion | Past | Accepting new patients |
Organizations & group practices 2
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": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534204800000",
"number": "1831262278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1677 EAST FLORENCE BLVD",
"address_2": "SUITE 24",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "85222",
"telephone_number": "520-836-5466",
"fax_number": "520-836-7469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 E ELLIOT RD STE 105",
"city": "TEMPE",
"state": "AZ",
"postal_code": "85284",
"telephone_number": "480-899-7996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELL",
"first_name": "EDWARD",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2018-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D6107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.