CANYON TRAILS DENTAL CARE, PC (NPI# 1043356058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043356058 |
| Entity Type | Organization |
| Organization Name | CANYON TRAILS DENTAL CARE, PC |
| Practice Address |
500 N Estrella Pkwy Suite B1 Goodyear AZ 85338-4135 |
| Practice Telephone | 6238820782 |
| Mailing Telephone | 6238820782 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK DELWYN WHEELER (OWNER DENTIST) |
| Authorized Official Telephone | 6238820782 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 5594 | AZ | Dental Providers |
| Street Address |
500 N ESTRELLA PKWY SUITE B1 |
| City | GOODYEAR |
| State | AZ |
| Zip Code | 85338-4135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760404602 | Frederick Charles Buensuceso | Optometrist | 500 N Estrella Pkwy, Goodyear, AZ 85338-4135 | 2006-07-23 |
| 1104282425 | Canyon Trails Family Dental, LLC | Dentist | 500 N Estrella Pkwy, Suite B-1, Goodyear, AZ 85338-4135 | 2016-01-04 |
| 1427354422 | Ebcon Optics LLC | Optometrist | 500 N Estrella Pkwy, Goodyear, AZ 85338-4135 | 2011-02-08 |
| 1396977880 | Ashley Ann Heid | Dentist | 500 N Estrella Pkwy, Suite B-1, Goodyear, AZ 85338-4135 | 2009-08-17 |
| 1487714283 | Brent Richard Stanley | Dentist | 500 N Estrella Pkwy, Suite B-1, Goodyear, AZ 85338-4135 | 2006-12-11 |
| 1598825374 | Mark Delwyn Wheeler | Dentist | 500 N Estrella Pkwy, Suite B-1, Goodyear, AZ 85338-4135 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226884 | Caroline Chang | Dentist | 15530 W Roosevelt St Ste E106, Goodyear, AZ 85338 | 2018-05-20 |
| 1609376714 | Rosanna Alvarez | Licensed Practical Nurse | 17432 W Elaine Dr, Goodyear, AZ 85338 | 2018-02-15 |
| 1023534419 | Jennifer Elizabeth Lawrence Dixon | Social Worker | 319 N Lichfield Rd, Suite 105, Goodyear, AZ 85338 | 2017-08-17 |
| 1346774916 | Vanessa Castillo | Specialist/Technologist | 18035 W. Yuma Rd, Goodyear, AZ 85338 | 2017-04-20 |
| 1386008076 | Hope Behavioral Health Residential Care | Substance Abuse Rehabilitation Facility | 15985 W.williams Street, Goodyear, AZ 85338 | 2016-04-08 |
| 1952760241 | Jeremy John Abdul-haqq | Dentist | 15661 W Roosevelt St Ste 102, Goodyear, AZ 85338 | 2016-02-16 |
| 1417206897 | Kelly Renee Filo | Occupational Therapy Assistant | 10189 S. Hacienda Dr., Goodyear, AZ 85338 | 2012-08-31 |
| 1194015545 | Nancy Ann Amore | Licensed Practical Nurse | 15578 W Yuma Road, Goodyear, AZ 85338 | 2011-04-19 |
| 1932409208 | Chung Counihan | Pharmacist | 9890 S Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| 1053611327 | Traven Anderson | Pharmacist | 9890 South Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| Find all providers in zip 85338 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417448812 | Tyler John Francis | Dentist | 960 S Sarival Ave Ste 120, Goodyear, AZ 85338-3010 | 2018-05-22 |
| 1295226884 | Caroline Chang | Dentist | 15530 W Roosevelt St Ste E106, Goodyear, AZ 85338 | 2018-05-20 |
| 1912497504 | Goodyear Modern Dentistry, LLP | Dentist | 15260 West Mcdowell Rd, Goodyear, AZ 85395 | 2018-05-18 |
| 1326491341 | Kallen Wheeler | Dentist | 14425 W Mcdowell Rd Ste F106, Goodyear, AZ 85395-2516 | 2016-07-14 |
| 1225442213 | Buenhombre Dental Pllc | Dentist | 15581 W Mackenzie Dr, Goodyear, AZ 85395-7779 | 2014-06-17 |
| 1336453166 | David T Sung | Dentist | 15530 W Roosevelt St, Goodyear, AZ 85338-6216 | 2010-08-04 |
| 1457581696 | Scott A Nielsen | Dentist | 781 S Cotton Ln Ste 100, Goodyear, AZ 85338-4643 | 2009-07-22 |
| 1093996845 | Joseph He Chang | Dentist | 14122 W Mcdowell Rd Ste 200, Goodyear, AZ 85395-2505 | 2007-11-21 |
| 1477763043 | Robin Paul Lenaker Jr. | Dentist | 2025 N Pebblecreek Pkwy, Suite A-11, Goodyear, AZ 85395 | 2007-05-23 |
| 1275663791 | Dan Nydegger | Dentist | 15661 W Roosevelt Pkwy, Suite 102, Goodyear, AZ 85338-9307 | 2007-03-06 |
| Find all providers in GOODYEAR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.