Individual provider Active NPI

Douglas Allen Pulsipher, D.D.S.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1871759043
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3246 Issued in AZ
Practice address
4350 E Ray Rd
Suite 116
Phoenix, AZ 85044-4703
Phone
(480) 706-0789
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3246 AZ Primary

Addresses

Primary practice location

4350 E Ray Rd
Suite 116
Phoenix, AZ 85044-4703

Mailing address

4350 E Ray Rd
Suite 116
Phoenix, AZ 85044-4703
Phone (480) 706-0789

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160308000785 AZ Order and Referring Only - DentistPractitioner - Dentist 5496051062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3246AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas a Pulsipher DDS PLLC General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1871759043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "address_2": "SUITE 116",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-706-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "address_2": "SUITE 116",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-706-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULSIPHER",
        "first_name": "DOUGLAS",
        "middle_name": "ALLEN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "3246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.