Individual provider Active NPI

Sigrid E Schwartz, D.D.S., M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Prescott, AZ
National Provider Identifier
1962413351
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D07927 Issued in AZ
Practice address
1200 Gail Gardner Way
Prescott, AZ 86305
Phone
(928) 777-8550
Fax
(928) 443-0142
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12009673A IN
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D07927 AZ Primary

Addresses

Primary practice location

1200 Gail Gardner Way
Prescott, AZ 86305

Mailing address

1200 Gail Gardner Way
Prescott, AZ 86305
Phone (928) 777-8550

Other names 1

  • Dr. Sigrid E. Tate Former name

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
I20170109001966 AZ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5698056596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009673AINMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Modern Dentistry, LLP 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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1962413351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GAIL GARDNER WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-777-8550",
            "fax_number": "928-443-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GAIL GARDNER WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-777-8550",
            "fax_number": "928-443-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "SIGRID",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12009673A",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D07927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIGRID",
            "last_name": "TATE",
            "middle_name": "E.",
            "prefix": "DR.",
            "credential": "DDS, MSD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.