DR. JODY B HERSCHENHORN-DOMINICK DDS
NPI 1770669939
Dentist - General Practice in Sacaton, AZ
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
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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).
Medicare Billing Reassignment
Medicare enrollment records show Jody Herschenhorn-dominick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sacaton, AZ 85147
- Reassigned Medicare billing, Texas enrollment
- 482 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
SACATON, AZ 85147
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.
Which organization bills Medicare for Jody Herschenhorn-dominick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jody Herschenhorn-dominick reassigns Medicare benefits to Gila River Health Care Corporation (Sacaton, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jody Herschenhorn-dominick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jody Herschenhorn-dominick accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 11 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.
# Dr. Jody B Herschenhorn-Dominick, DDS · NPI 1770669939
General Practice provider in Sacaton, Arizona. Individual provider, active in the CMS NPPES registry since October 31, 2006.
## Identity
- **NPI:** 1770669939 (Entity type: Individual)
- **Enumerated:** October 31, 2006
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 5247 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 483 W. SEED FARM RD., Sacaton, AZ 85147-0038
- **Phone:** (602) 528-1200 · **Fax:** (602) 528-1296
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Gila River Health Care Corporation (NPI 1225023179, Sacaton, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 8, 2012
- **Other identifiers:** Medicaid 771768 (AZ); Other AZ0479240 (AZ); Other 873865 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1770669939) · Data from the CMS NPPES public registry.