JENNIFER CANADA


Address: 6725 N 35th Ave # 105, Phoenix, AZ 85017-1083
Phone: 6025955230

JENNIFER CANADA (NPI# 1124401146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124401146
Entity Type Individual
Full Name JENNIFER CANADA
Credential DMD
Practice Address 6725 N 35th Ave # 105
Phoenix
AZ 85017-1083
Mailing Address 6725 N. 35th Ave., #105
Phoenix
AZ 85017
Practice Telephone 6025955230
Practice Fax Number 6025955280
Mailing Telephone (602) 595-5230
Mailing Fax Number 6025955280
Enumeration Date 2015-07-08
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
9796 AZ Dental Providers
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Brookdale Plz, Brooklyn, NY 112123139 7182405021

Office Location

Street Address 6725 N 35TH AVE # 105
City PHOENIX
State AZ
Zip Code 85017-1083

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477169282 Deborah Carter Specialist/Technologist 5346 N. 29th Ave., Phoenix, AZ 85017 2020-09-17
1730671207 Michael Carl Smith Assisted Living Facility 5736 N 33rd Ave, Phoenix, AZ 85017 2018-05-31
1457860561 Bianca Yvonne Lopez Psychiatry & Neurology 3001 N. 33rd Ave, Phoenix, AZ 85017 2017-09-21
1295259281 Happy Home Care Home Health 4550 N. Black Canyon Hwy Road, Phoenix, AZ 85017 2017-08-01
1851848493 Horeb Transportation LLC Non-emergency Medical Transport (VAN) 5718 N Black Canyon Hwy, 36, Phoenix, AZ 85017 2016-09-01
1932565942 Urgent Pain, LLC Contractor 6025 N. 27th Ave, Suite 6, Phoenix, AZ 85017 2016-01-06
1457766172 Lindsay Allison Love Social Worker 3306 W. Catalina Dr., Phoenix, AZ 85017 2014-06-23
1437592433 Maya Medical Services Clinic/Center 2908 W. Camelback Rd., Phoenix, AZ 85017 2013-04-10
1801089685 Jonnie Arnold Counselor 3400 Grand Ave, Phoenix, AZ 85017 2007-08-24
1851414890 Corpus Christi Home Care and Hospice LLC Hospice Care, Community Based 3001 W Indian School Rd, Suite #26, Phoenix, AZ 85017 2007-04-06
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881206274 Totally Kids Dental P.C. Dentist 602 W Union Hills Dr Ste 9, Phoenix, AZ 85027-6629 2020-08-18
1861989121 Logan Mariano Dentist 4383 E Rosemonte Dr, Phoenix, AZ 85050-3407 2018-04-21
1972023372 David Jourabchi Dentist 4550 E Bell Rd Ste 106, Phoenix, AZ 85032-9342 2017-06-27
1730639840 Steven Petruzzi Dds Pllc Dentist 34406 N 27th Dr Ste 106, Phoenix, AZ 85085-7730 2016-10-12
1548654791 Arlene Kewallal Dentist 1935 W Happy Valley Rd, Phoenix, AZ 85085-2884 2015-03-25
1134400880 Norterra Pediatric Dental Partners, LLP Dentist 2217 W Happy Valley Rd Ste 100, Phoenix, AZ 85085-1604 2011-09-07
1558689703 Hamed Rezakhan Dentist 4803 E Ray Rd, Suit P002c, Phoenix, AZ 85044-6496 2010-05-12
1417110750 Shreekrishna Chaitanya Akilesh Dentist 10550 W Mariposa St, Phoenix, AZ 85037-5081 2008-07-07
1134345937 Pda Holdings Dentist 1701 E Thomas Rd #204, Phoenix, AZ 85016 2007-04-18
1902936677 William J. Heimann Dentist 1526 W Glendale Ave Ste 103, Phoenix, AZ 85021-8576 2007-03-06
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Competitor

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City PHOENIX
Zip Code 85017

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Dataset Information

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.

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