Individual provider Active NPI

Kevin Allen Rauter, DDS

  • General Practice Dentistry
  • Fountain Hills, AZ
National Provider Identifier
1972505022
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AZ4367 Issued in AZ
Practice address
16921 E Palisades Blvd
Ste 111
Fountain Hills, AZ 85268-8411
Phone
(480) 816-1011
Fax
(480) 816-8063
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AZ4367 AZ Primary

Addresses

Primary practice location

16921 E Palisades Blvd
Ste 111
Fountain Hills, AZ 85268-8411

Mailing address

16921 E Palisades Blvd
Ste 111
Fountain Hills, AZ 85268-8411
Phone (480) 816-1011

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
I20160122001614 AZ Order and Referring Only - DentistPractitioner - Dentist 9133422298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ4367AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972505022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16921 E PALISADES BLVD",
            "address_2": "STE 111",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688411",
            "telephone_number": "480-816-1011",
            "fax_number": "480-816-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16921 E PALISADES BLVD",
            "address_2": "STE 111",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688411",
            "telephone_number": "480-816-1011",
            "fax_number": "480-816-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUTER",
        "first_name": "KEVIN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ4367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

Verify at the official NPI Registry.