Individual provider Active NPI

Alexander Rafael Ordonez, DDS

  • Dentist
  • Oro Valley, AZ
National Provider Identifier
1932776903
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011044 Issued in AZ
Practice address
1880 E Tangerine Rd Ste 190
Oro Valley, AZ 85755-6239
Phone
(520) 544-5590
NPI assigned
Jun 8, 2021
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D011044 AZ Primary

Addresses

Primary practice location

1880 E Tangerine Rd Ste 190
Oro Valley, AZ 85755-6239

Mailing address

11177 N Oracle Rd Apt 2301
Oro Valley, AZ 85737-5621

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
I20210922003736 AZ Order and Referring Only - DentistPractitioner - Dentist 3870990690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D011044AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tangerine Dental Group, LLP PastSince Jun 15, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1932776903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11177 N ORACLE RD APT 2301",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857375621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 E TANGERINE RD STE 190",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556239",
            "telephone_number": "520-544-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDONEZ",
        "first_name": "ALEXANDER",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oro Valley, AZ

Sources for this page

Verify at the official NPI Registry.