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DR. JODY B HERSCHENHORN-DOMINICK DDS
NPI 1770669939
Dentist - General Practice in Sacaton, AZ

Active since October 31, 2006PECOS Enrolled
483 W. SEED FARM RD., SACATON, AZ 85147(602) 528-1200(602) 528-1296 Get Directions Write a Review

NPPES record last updated: March 8, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jody B Herschenhorn-dominick Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JODY B HERSCHENHORN-DOMINICK DDS (NPI 1770669939) is an individual general practice provider in Sacaton, Arizona, licensed in Arizona (5247) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770669939
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JODY B HERSCHENHORN-DOMINICKCredential: DDS
Location Address483 W. SEED FARM RD.Sacaton, AZ 85147-0038
Mailing AddressPo Box 38, Gila River Health Care CorporationSacaton, AZ 85147-0038 · (602) 528-1200 · Fax (602) 528-1255
Phone(602) 528-1200
Fax(602) 528-1296
Sole ProprietorNo
Enumeration DateOctober 31, 2006
Last NPPES UpdateMarch 8, 2012
✔ NPI 1770669939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in AZ · 5247
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
483 W. SEED FARM RD., Sacaton, AZ 85147
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Other Identifiers 3

Medicaid771768AZ
OtherAZ0479240AZ · Bcbs Provider Number
Other873865AZ · United Concordia Dental

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jody B Herschenhorn-dominick Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85147 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CONNIE GIGOUS FNP
Nurse Practitioner (Family)
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200
JOAN E LAZORE FNP-C
Nurse Practitioner (Family)
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200
DR. MONICA A LUMPKIN M.D.
Family Medicine
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200
DR. NGUYET MINH KHA DDS
Dentist (General Practice)
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200
GILA RIVER HEALTH CARE CORPORTION
General Acute Care Hospital (Critical Access)
483 W. SEED FARM RD., CREDENTIALING
SACATON, AZ 85147
Pinal County (602) 528-1340
LYNN MARIE PACHECO LCSW
Social Worker (Clinical)
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200
MAILI HUCK CAREY RD, CDE
Dietitian, Registered
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200
MS. CHERIE KEMPER R.D.
Dietitian, Registered
483 W. SEED FARM RD.
SACATON, AZ 85147
Pinal County (602) 528-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jody Herschenhorn-dominick's NPI number?

The NPI number for Jody Herschenhorn-dominick is 1770669939. It was assigned to this individual provider in the NPPES registry on October 31, 2006.

Where is Jody Herschenhorn-dominick located?

Jody Herschenhorn-dominick practices at 483 W. Seed Farm Rd., Sacaton, AZ 85147. The listed phone number is (602) 528-1200.

What is Jody Herschenhorn-dominick's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jody Herschenhorn-dominick enrolled in Medicare?

Yes. Jody Herschenhorn-dominick is registered in the Medicare PECOS enrollment system.

What insurance does Jody Herschenhorn-dominick accept?

Health plans from Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 6 other insurers list Jody Herschenhorn-dominick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jody Herschenhorn-dominick was last updated on March 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.