PHOENIX PEDIATRIC DENTAL (NPI# 1437547775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437547775 |
| Entity Type | Organization |
| Organization Name | PHOENIX PEDIATRIC DENTAL |
| Practice Address |
6750 N 19th Ave Phoenix AZ 85015-1127 |
| Mailing Address |
5400 W Northern Ave Glendale AZ 85301-1406 |
| Practice Telephone | 6022425741 |
| Practice Fax Number | 6022425742 |
| Mailing Telephone | 6022425741 |
| Mailing Fax Number | 6022425742 |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |
| Authorized Official Name | LUZ PACHECO (HUMAN RESOURCE) |
| Authorized Official Telephone | 6022425741 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D5353 | AZ | Dental Providers |
| Street Address |
6750 N 19TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639152184 | Neal Jared Nation | Dentist | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2005-11-29 |
| 1780113944 | Robbie Frank Harrell | Dentist | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2017-06-09 |
| 1205270386 | Phoenix Orthodontics LLC | Dentist | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2013-04-19 |
| 1154621548 | Therapyworx, LLC | Home Health | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2010-11-01 |
| 1720241052 | Eric Edwin Jacobsen | Dentist | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2008-07-07 |
| 1659580595 | Francisco H Bezerra | Dentist | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2007-05-21 |
| 1891875498 | Phoenix Pediatric Dental, LLC | Dentist | 6750 N 19th Ave, Phoenix, AZ 85015-1127 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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 |
| 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 |
| 1124401146 | Jennifer Canada | Dentist | 6725 N 35th Ave # 105, Phoenix, AZ 85017-1083 | 2015-07-08 |
| 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 |
| Find all providers in PHOENIX | ||||
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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.