Ariel E. Trujillo, D.M.D

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6014 Issued in AZ

Practice address

1717 W Northern Ave
Ste #104
Phoenix, AZ 85021-5469

Phone

(602) 995-5045

Fax

(602) 995-3222

NPI assigned

May 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 10, 2015 through Nov 10, 2027

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Arizona Periodontal Group PLLC

  • Periodontics
  • Phoenix, AZ
  • NPI 1134338973
  NPD (past) Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1992913594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE",
            "address_2": "STE #104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215469",
            "telephone_number": "602-995-5045",
            "fax_number": "602-995-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE",
            "address_2": "STE #104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215469",
            "telephone_number": "602-995-5045",
            "fax_number": "602-995-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "ARIEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "6014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Truespan Health LLC
• Kaitlin Truett
• Corrina Symone Truitt
• Karen Ann Truitt, DO
• Kevin J Truitt, DPT
• Brandon Sean Trujillo
• Cristal Eliza Trujillo, RBT
• Dalila Trujillo
• Evelyn Guadalupe Arciniega Trujillo
• Jessica K Trujillo, RPH

• Periodontics in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.