Daniel Colin Fedyszyn, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011037 Issued in AZ

Practice address

16251 N Cave Creek Rd
Phoenix, AZ 85032-2976

Phone

(480) 882-4545

Fax

(602) 409-0499

NPI assigned

Jun 4, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dfedyszyn607535@direct.ochin.org

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.

• Neighborhood Outreach Access to Health

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1942518550

  General Practice

  Medicare reassignment NPD
• Neighborhood Outreach Access to Health

  • Federally Qualified Health Center (FQHC)
  • Glendale, AZ
  • NPI 1326731555
  NPD
• Embrace Dentistry Dakota Dunes LLC

  • Dental Clinic/Center
  • North Sioux City, SD
  • NPI 1174153985
  NPD (past)
• Holland Dental

  • Dental Clinic/Center
  • Dakota Dunes, SD
  • NPI 1649471327
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1992297071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16251 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322976",
            "telephone_number": "480-882-4545",
            "fax_number": "602-409-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDYSZYN",
        "first_name": "DANIEL",
        "middle_name": "COLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D1187",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105129",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Federal Correctional Institution
• Diana Federico
• Sandra Brigitte Fedie, MSN, RN, FNP, WCC
• Melissa Fedt, RD
• John Edward Fedyna, R.PH
• Feed Corp
• Feeding Bliss PLLC
• Feel Good Naturally Inc
• Anne M Feeney
• Melissa S Fees, PHD

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.