Individual provider Active NPI

Rommel Youel Dinkha, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1912960873
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6634 Issued in AZ
Practice address
1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228
Phone
(623) 434-9343
Fax
(623) 321-6268
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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 D6634 AZ Primary

Addresses

Primary practice location

1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228

Mailing address

1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228
Phone (623) 434-9343

Other identifiers 1

IdentifierTypeStateIssuer
997637MedicaidAZ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
D6634AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1912960873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "623-434-9343",
            "fax_number": "623-321-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "623-434-9343",
            "fax_number": "623-321-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINKHA",
        "first_name": "ROMMEL",
        "middle_name": "YOUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "997637",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.