npidexNPI registry + Medicare data

ANITA FOUNTAIN, DDS

General Practice Dentistry · GOODYEAR, AZ

Individual Active Opted out of Medicare NPI 1902834005

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
General Practice Dentistry1223G0001X✓D2179AZ
General Practice Dentistry1223G0001X2413-015WI

Medicare eligibility

Part B
Yes
DME
Yes
Home health
Yes
Power mobility
No
Hospice
Yes

Opted out of Medicare (Oral Surgery), effective 2015-09-22 through 2027-09-22.

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.