Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1366531402 Individual Practitioner Male Practitioner

Dr. Derrick J Dickerson , DMD

Dentist - General Practice • Mesa, AZ

Professional Overview & Biography Verified Profile Summary

Dr. Derrick Dickerson, DMD is a registered healthcare professional specializing in Dentist - General Practice in Mesa, AZ. Practice services are available at 6755 E SUPERSTITION SPRINGS BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6755 E Superstition Springs Blvd
203

Mesa, AZ 85206

Telephone 4802186030
Fax 4802186057
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Mesa, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.4 Yrs
Regional Practice Density
228 Specialists

Practicing in Mesa, AZ (2600 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AZ 4940

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Dr. Bradley Porter , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1023095734

Doctor of Dental Surgery

Dr. Morley Smith , DMD, PC

Dentist - Periodontics

NPI 1235139429

Doctor of Dental Medicine, PC

Dr. Arlon Petersen , DMD

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1245447499

Doctor of Dental Medicine

Dr. Mark Hamblin , DDS

Dentist - General Practice

NPI 1558584045

Doctor of Dental Surgery

Dr. Brent Boyse , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1609853365

Doctor of Dental Surgery

Dr. Treven Rollins , DMD

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1841491255

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 6755 E SUPERSTITION SPRINGS BLVD, 203, MESA, AZ 85206 (Tel: 4802186030)

📍
Updated Business Mailing Address July 08, 2007

Registered at 6755 E SUPERSTITION SPRINGS BLVD, 203, MESA, AZ 85206 (Tel: 4802186030)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as DERRICK DICKERSON, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #4940 in AZ)

🟢
Initial NPI Registration & Enumeration October 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366531402
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 12, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

6755 E Superstition Springs Blvd, 203

Mesa, AZ 85206

Phone: 4802186030

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.