DESERT STATE DENTAL ANESTHESIA, LLC (NPI# 1407994676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407994676 |
| Entity Type | Organization |
| Organization Name | DESERT STATE DENTAL ANESTHESIA, LLC |
| Practice Address |
625 W Southern Ave Ste E-145 Mesa AZ 85210-5030 |
| Practice Telephone | 4803325541 |
| Practice Fax Number | 8668141886 |
| Mailing Telephone | 4803325541 |
| Mailing Fax Number | 8668141886 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2016-06-29 |
| Authorized Official Name | DR. REUBEN NELSON TURNER (MANAGER) |
| Authorized Official Telephone | 4803325541 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 884644 | 05 |
| Street Address |
625 W SOUTHERN AVE STE E-145 |
| City | MESA |
| State | AZ |
| Zip Code | 85210-5030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184799538 | Reuben Nelson Turner | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2006-11-21 |
| 1962785097 | Bradley L Farr | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2011-09-26 |
| 1629214820 | Matthew Ryan Wall | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2008-12-18 |
| 1295893196 | Spencer K. Wilde | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184799538 | Reuben Nelson Turner | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2006-11-21 |
| 1811066541 | Mari Cynthia Fukami | Dentist | 625 W Southern Ave, Ste E-145, Mesa, AZ 85210-5030 | 2006-11-07 |
| 1972864528 | Aaron Legrand Roberts | Dentist | 625 W Southern Ave, Ste E-145, Mesa, AZ 85210-5030 | 2012-05-30 |
| 1962785097 | Bradley L Farr | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2011-09-26 |
| 1295893196 | Spencer K. Wilde | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699252544 | Green States Anesthesia Pllc | Dentist | 3343 E Indigo Bay Ct, Gilbert, AZ 85234-1737 | 2018-07-24 |
| 1760847628 | Sleepcare Dental LLC | Dentist | 625 W Deer Valley Rd Ste 103622, Phoenix, AZ 85027-2138 | 2015-12-20 |
| 1326420415 | Trent Nielsen | Dentist | 12417 W Encanto Blvd, Avondale, AZ 85392-6515 | 2015-06-24 |
| 1144660358 | Thanh Hoang Phan | Dentist | 14100 N 83rd Ave Ste 280, Peoria, AZ 85381-5660 | 2013-07-02 |
| 1376108035 | Tcp Anesthesia Services Pllc | Dentist | 695 E Cottonwood Ln, Casa Grande, AZ 85122-2023 | 2019-05-07 |
| 1881185791 | Comfort Care Anesthesia, LLC | Dentist | 13601 N Canterbury Dr, Phoenix, AZ 85023-6290 | 2018-05-25 |
| 1689025256 | Arizona Dental Anesthesia Pllc | Dentist | 14100 N 83rd Ave Ste 280, Peoria, AZ 85381-5660 | 2016-06-24 |
| 1700241809 | Arizona Anesthesia for Dentistry, LLC | Dentist | 6600 N Oracle Rd, Ste 110, Tucson, AZ 85704-5676 | 2015-12-16 |
| 1447641139 | Minsoek Kang Dentistry, Pllc | Dentist | 15033 W Bell Rd, Ste 175, Surprise, AZ 85374-3217 | 2015-02-17 |
| 1518366111 | East Valley Dental Anesthesia, Pllc | Dentist | 67 S Higley Rd, Suite 103, Gilbert, AZ 85296-1166 | 2014-08-19 |
| Find all providers with the same taxonomy | ||||
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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.