Individual provider Active NPI

Jeremy Garrett, DMD

  • Dentist
  • Buckeye, AZ
National Provider Identifier
1962564641
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6959 Issued in AZ
Practice address
20800 W Market St Ste 103
Buckeye, AZ 85396-8040
Phone
(602) 858-9956
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6959 AZ Primary
Dentist 122300000X D6959 AZ

Addresses

Primary practice location

20800 W Market St Ste 103
Buckeye, AZ 85396-8040

Mailing address

20800 W Market St Ste 103
Buckeye, AZ 85396-8040
Phone (602) 858-9956

Other practice location 1

10750 W McDowell Rd Ste F610
Avondale, AZ 85392-5976
Phone (480) 581-9591

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
D6959AZMDDentist
6959AZMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1962564641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 W MARKET ST STE 103",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853968040",
            "telephone_number": "602-858-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20800 W MARKET ST STE 103",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853968040",
            "telephone_number": "602-858-9956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10750 W McDowell Rd Ste F610",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853925976",
            "country_code": "US",
            "telephone_number": "480-581-9591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "6959",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D6959",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.