Active NPI
Eugene Salazar, DDS, MSD
- Endodontics
- Phoenix, AZ
National Provider Identifier
1972713493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- D4147
- Practice address
- 706 E Bell Rd Ste 104
Phoenix, AZ 85022 - Phone
- (602) 482-7000
- Fax
- (602) 482-7021
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4147 | AZ | |
| Endodontics | 1223E0200X | D4147 | AZ | Primary |
Addresses
Primary practice location
706 E Bell Rd Ste 104
Phoenix, AZ 85022
Mailing address
16080 N 59TH Ave
Glendale, AZ 85306-2339
Phone (602) 978-1100
Other practice location 1
16080 N 59th Ave
Glendale, AZ 85306-2339
Phone (602) 978-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86-079974 | Other | AZ | TIN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| D4147 | AZ | MD | Endodontist |
| 4147 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Valley Endodontics, P.a. | Endodontics | Past | Accepting new patients |
| Midwestern University | Past | Accepting new patients |
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.
-
- Dental Clinic/Center
- Glendale, AZ
- NPI 1164744009
-
- Endodontics
- Phoenix, AZ
- NPI 1659308641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536537600000",
"number": "1972713493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16080 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853062339",
"telephone_number": "602-978-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 E BELL RD STE 104",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85022",
"telephone_number": "602-482-7000",
"fax_number": "602-482-7021"
}
],
"practiceLocations": [
{
"address_1": "16080 N 59th Ave",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "AZ",
"postal_code": "853062339",
"country_code": "US",
"telephone_number": "602-978-1100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SALAZAR",
"first_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2018-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "4147",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "AZ",
"license": "D4147",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TIN",
"identifier": "86-079974",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.