Individual provider Active NPI

Alexander Homer, DMD

  • Endodontics
  • Mesa, AZ
National Provider Identifier
1962186734
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D012471 Issued in AZ
Practice address
4338 E Florian Ave Ste 104
Mesa, AZ 85206-2688
Phone
(480) 396-6100
NPI assigned
Jun 12, 2023
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D012471 AZ Primary

Addresses

Primary practice location

4338 E Florian Ave Ste 104
Mesa, AZ 85206-2688

Mailing address

5750 S 101St Way
Mesa, AZ 85212-1165
Phone (605) 759-6279

Other practice location 1

18610 E Rittenhouse Rd Ste 104
Queen Creek, AZ 85142-4504
Phone (480) 988-0020

Other practice location 2

3048 E Baseline Rd Ste 111
Mesa, AZ 85204-7287
Phone (480) 969-4774

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D012471AZMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1962186734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 S 101ST WAY",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852121165",
            "telephone_number": "605-759-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4338 E FLORIAN AVE STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062688",
            "telephone_number": "480-396-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18610 E Rittenhouse Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851424504",
            "country_code": "US",
            "telephone_number": "480-988-0020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3048 E Baseline Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852047287",
            "country_code": "US",
            "telephone_number": "480-969-4774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOMER",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D012471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.