Individual provider Active NPI

Cody Heslington, DMD

  • Endodontics
  • Peoria, AZ
National Provider Identifier
1962818633
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D009608 Issued in AZ
Practice address
21755 N 77TH Ave Ste 1210
Peoria, AZ 85382-2112
Phone
(623) 248-0899
Fax
(623) 248-9951
NPI assigned
Jul 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 9608 AZ
Student in an Organized Health Care Education/Training Program 390200000X 30407 IA
Endodontics 1223E0200X D009608 AZ Primary

Addresses

Primary practice location

21755 N 77TH Ave Ste 1210
Peoria, AZ 85382-2112

Mailing address

21755 N 77TH Ave Ste 1210
Peoria, AZ 85382-2112
Phone (623) 248-0899

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
D009608AZMDEndodontist
30407IAMDDiagnostic Radiology Physician
9608AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Black Mountain Endodontics Endodontics CurrentSince Oct 2, 2022 Accepting new patients
North Valley Endodontics, P.a. Endodontics Past Accepting new patients

Locations

21755 N 77th Ave
Ste 1210
Peoria, AZ 85382
Phone (623) 248-0899

Organizations & group practices 2

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1962818633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21755 N 77TH AVE STE 1210",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822112",
            "telephone_number": "623-248-0899",
            "fax_number": "623-248-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21755 N 77TH AVE STE 1210",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822112",
            "telephone_number": "623-248-0899",
            "fax_number": "623-248-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESLINGTON",
        "first_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "9608",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "30407",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D009608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.