Kevin T Axx, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D7377 Issued in AZ

Practice address

4141 N 32ND St Ste 100
Phoenix, AZ 85018-4775

Phone

(602) 667-3600

Fax

(602) 667-3611

NPI assigned

Sep 13, 2006

Last updated

Aug 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Arcadia Endodontic Partners PLLC

  dba Arcadia Endodontics

  • Endodontics
  • Phoenix, AZ
  • NPI 1659033165
  NPD
• North Valley Endodontics, P.a.

  dba Valley Endodontic Specialty Group

  • Endodontics
  • Phoenix, AZ
  • NPI 1659308641
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1831294032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E LEXINGTON AVE UNIT 1010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122494",
            "telephone_number": "602-667-3600",
            "fax_number": "602-667-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 N 32ND ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850184775",
            "telephone_number": "602-667-3600",
            "fax_number": "602-667-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXX",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "050281",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D7377",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS036316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brittany Justine Ayala-Patlan, WHNP
• Monica Ayala, SRN

• Endodontics in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Endodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.