Individual provider Active NPI

Emily Alena Serrano, DMD, MS, MPH

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Phoenix, AZ
National Provider Identifier
1952170383
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D011976 Issued in AZ
Practice address
1515 E Missouri Ave
Phoenix, AZ 85014-2446
Phone
(602) 536-6842
NPI assigned
Dec 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D011976 AZ Primary

Addresses

Primary practice location

1515 E Missouri Ave
Phoenix, AZ 85014-2446

Mailing address

4435 N 78TH St Apt 230a
Scottsdale, AZ 85251-2561

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eserrano694064@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20240726002531 UT Practitioner - Orthodontics and Dentofacial Orthopedics 5799221636 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D011976AZMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Jun 15, 2024 Accepting new patients
University of Utah Pediatric Services CurrentSince Jun 15, 2024 Accepting new patients
University of Utah Pediatric Services CurrentSince Jun 15, 2024 Accepting new patients
University of Utah Dental Services CurrentSince Jun 15, 2024 Accepting new patients
University of Utah Dental Services CurrentSince Jun 15, 2024 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jun 15, 2024 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services Past Accepting new patients

Locations

127 S 500 E
Ste 400
Salt Lake City, UT 84102

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Interoperability endpoints

  • Direct secure messaging: eserrano694064@direct.med.utah.edu

Organizations & group practices 9

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741478400000",
    "number": "1952170383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 N 78TH ST APT 230A",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142446",
            "telephone_number": "602-536-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "EMILY",
        "middle_name": "ALENA",
        "credential": "DMD, MS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-27",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D011976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eserrano694064@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.