Active NPI
Sam Palmer
- Dentist
- Phoenix, AZ
National Provider Identifier
1992962922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D 2102
- Practice address
- 2744 E Corrine Dr
Phoenix, AZ 85032-6960 - Phone
- (602) 992-1219
- NPI assigned
- May 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D 2102 | AZ | Primary |
Addresses
Primary practice location
2744 E Corrine Dr
Phoenix, AZ 85032-6960
Mailing address
2744 E Corrine Dr
Phoenix, AZ 85032-6960
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 |
|---|---|---|---|
| D 2102 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1992962922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2744 E CORRINE DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850326960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2744 E CORRINE DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850326960",
"telephone_number": "602-992-1219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "SAM",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D 2102",
"primary": true
}
],
"identifiers": [],
"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 May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.