CANYON MODERN DENTISTRY & ORTHODONTICS (NPI# 1366848897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366848897 |
| Entity Type | Organization |
| Organization Name | CANYON MODERN DENTISTRY & ORTHODONTICS |
| Practice Address |
17081 W Greenway Rd Suite 120 Surprise AZ 85388-9612 |
| Practice Telephone | 6235468400 |
| Practice Fax Number | 6232145830 |
| Mailing Telephone | 6235468400 |
| Mailing Fax Number | 6232145830 |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2014-11-11 |
| Authorized Official Name | DR. MOHAMMED REZA KHAKWANI (GENERAL DENTIST) |
| Authorized Official Telephone | 3167276886 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D009075 | AZ | Ambulatory Health Care Facilities |
| Street Address |
17081 W GREENWAY RD SUITE 120 |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85388-9612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033235734 | Amish B Patel | Dentist | 17081 W Greenway Rd, Suite 121, Surprise, AZ 85388-9612 | 2007-03-22 |
| 1538557525 | Mohammed Reza Khakwani | Dentist | 17081 W Greenway Rd, Suite 120, Surprise, AZ 85388-9612 | 2014-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508410887 | Kids Dentists of Surprise and Orthodontics, LLP | Dentist | 15180 N. Cotton Lane, Suite 104, Surprise, AZ 85388 | 2019-07-25 |
| 1588148803 | Moahk Behavioral Home LLC | Assisted Living Facility | 16645 West Central Street, Surprise, AZ 85388 | 2018-09-21 |
| 1881118867 | Haja Sankoh | Behavior Technician | 16645 West Central St, Surprise, AZ 85388 | 2017-08-01 |
| 1235516675 | Benjamin J Hegenbarth | Family Medicine | 14981 Nth 174 Dr., Surprise, AZ 85388 | 2015-05-06 |
| 1447644521 | Urgent Care Centers of Arizona, LLC | Clinic/Center | 16840 W. Waddell Road, Suite 110, Surprise, AZ 85388 | 2015-03-26 |
| 1548512239 | We Care Medical Supply Plus | Durable Medical Equipment & Medical Supplies | 17317 W. Banff Lane, Surprise, AZ 85388 | 2012-10-05 |
| 1376871095 | Rebecca Kimberly Adamoli | Nurse's Aide | 17999 N. Surprise Farms Loop South, Surprise, AZ 85388 | 2009-11-19 |
| 1417281395 | Tracy Dunbar | Respite Care | 18245 West Port Royale Ln., Surprise, AZ 85388 | 2009-09-25 |
| 1467696617 | Eileen Georgina Soltis | Registered Nurse | 17359 W. Surprise Farms Loop N, Surprise, AZ 85388 | 2009-04-30 |
| 1538306360 | Wholistic Integrative Caring Network LLC | Nurse Practitioner | 16278 N. 164th Lane, Surprise, AZ 85388 | 2009-01-15 |
| Find all providers in zip 85388 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649888629 | Whitney A Sebree, Dmd Pllc | Clinic/Center | 15331 W Bell Rd Ste 204, Surprise, AZ 85374-4104 | 2020-07-16 |
| 1912538497 | Dental Depot of Surprise, Pllc | Clinic/Center | 13828 W. Greenway Rd., Surprise, AZ 85374 | 2020-02-03 |
| 1447728654 | Steele Dental Group | Clinic/Center | 15409 W Greenway Rd Ste 100, Surprise, AZ 85374-4368 | 2018-11-06 |
| 1922594522 | Ebw Dmd Pllc | Clinic/Center | 14800 W Mountain View Blvd Ste 200, Surprise, AZ 85374-2703 | 2018-07-06 |
| 1770005233 | Surprise Implants & Family Dentistry | Clinic/Center | 14967 W Bell Rd, Ste 100, Surprise, AZ 85374 | 2017-07-16 |
| 1861879066 | Adelante Healthcare Inc | Clinic/Center | 15317 W Bell Rd Ste 108, Surprise, AZ 85374-3901 | 2015-04-27 |
| 1427656503 | Wynn Dental Corporation | Clinic/Center | 16581 W Bell Rd Ste 108, Surprise, AZ 85374-0004 | 2020-10-12 |
| 1114462330 | Surprise Pediatric Dentistry, PC | Clinic/Center | 15331 W Bell Rd, Suite #112, Surprise, AZ 85374-4102 | 2016-12-23 |
| 1033520671 | Sk Dental LLC | Clinic/Center | 15288 W Brookside Ln, Building D Suite 131, Surprise, AZ 85374-3990 | 2014-05-16 |
| 1437394731 | Southwestern Smile Design, LLC | Clinic/Center | 18775 N Reems Rd, C-300, Surprise, AZ 85374-8647 | 2008-12-16 |
| Find all providers in SURPRISE | ||||
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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.