94TH DRIVE, LLC (NPI# 1174769590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174769590 |
| Entity Type | Organization |
| Organization Name | 94TH DRIVE, LLC |
| Other Organization Name | PEORIA DENTISTRY |
| Practice Address |
13660 N 94th Dr B-1 Peoria AZ 85381-4836 |
| Practice Telephone | 6239772551 |
| Practice Fax Number | 6239779515 |
| Mailing Telephone | 6239772551 |
| Mailing Fax Number | 6239779515 |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |
| Authorized Official Name | MISS FAWNE E PRYOR (INSURANCE MANAGER) |
| Authorized Official Telephone | 6235823902 |
| Authorized Official Credential | MGR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D6772 | AZ | Dental Providers |
| Other Name | Type Code |
|---|---|
| Peoria Dentistry | Doing Business As Name - Organization |
| Street Address |
13660 N 94TH DR B-1 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437156031 | Jeffrey C Kleiman | Dentist | 13660 N 94th Dr, Ste E3, Peoria, AZ 85381-4209 | 2005-06-28 |
| 1346851276 | Galaxy Anesthesia Services, LLC | Anesthesiology | 13660 N 94th Dr, D-1, Peoria, AZ 85381-8538 | 2020-08-13 |
| 1912338393 | Ashley Patricia Chung | Naturopath | 13660 N 94th Dr, Ste. C-4, Peoria, AZ 85381-4836 | 2013-12-10 |
| 1689939985 | Annie Jong | Podiatrist | 13660 N 94th Dr, Ste A3, Peoria, AZ 85381-4836 | 2012-07-12 |
| 1013216373 | Keith Thomas Bangart | Podiatrist | 13660 N 94th Dr, #f1, Peoria, AZ 85381-4836 | 2011-03-24 |
| 1205152022 | Sunshine Health Care Center | Family Medicine | 13660 N 94th Dr, Suite C4, Peoria, AZ 85381-4841 | 2010-04-19 |
| 1619290129 | Walker Dental | Dentist | 13660 N 94th Dr, Suite B-1, Peoria, AZ 85381-4836 | 2010-03-11 |
| 1104148741 | Pacific Footwear Company, Inc | Durable Medical Equipment & Medical Supplies | 13660 N 94th Dr, Suite F-2, Peoria, AZ 85381-4836 | 2010-02-24 |
| 1821221847 | Tiffany Nicole Mitchell | Naturopath | 13660 N 94th Dr, Ste C-4, Peoria, AZ 85381-4836 | 2009-08-25 |
| 1134359425 | Plaza Del Rio Dentistry, LLC | Dentist | 13660 N 94th Dr, Suite B1, Peoria, AZ 85381-4836 | 2009-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| 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 |
|---|---|---|---|---|
| 1386258689 | Joshua Dutton | Dentist | 8325 W Happy Valley Rd Unit 100, Peoria, AZ 85383-4361 | 2020-09-03 |
| 1750908992 | Asfia Kauser | Dentist | 4325 W Castleton Rd, Peoria, IL 61615-2821 | 2020-07-04 |
| 1528694247 | Lake Pleasant Kids Dentists and Orthodontics, LLP | Dentist | 24775 North Lake Pleasant Parkway Suite 104, Peoria, AZ 85383 | 2020-03-13 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1669958781 | Plaza Family Dental Inc | Dentist | 9145 W Thunderbird Rd Ste H105, Peoria, AZ 85381-4820 | 2018-07-11 |
| 1578058293 | Bhumikaben Patel | Dentist | 5400 W Sienna Ln Apt 2202, Peoria, IL 61615-7857 | 2018-06-25 |
| 1265926729 | Vogue Dental Peoria LLC | Dentist | 3510 N University St Ste A, Peoria, IL 61604-1346 | 2018-06-19 |
| 1841784493 | Jeffrey Jay Chen | Dentist | 9016 N Allen Rd Ste B, Peoria, IL 61615-1560 | 2018-06-18 |
| 1013422138 | Joseph Nicholas Taylor | Dentist | 7310 N Villa Lake Dr Ste B, Peoria, IL 61614-8268 | 2017-12-12 |
| 1457881351 | Jaclyn Macdonald | Dentist | 2214 N University St, Peoria, IL 61604-3221 | 2017-06-14 |
| Find all providers in PEORIA | ||||
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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.