KS AZ-1, PC (NPI# 1588759161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588759161 |
Entity Type | Organization |
Organization Name | KS AZ-1, PC |
Other Organization Name | KOOL SMILES |
Practice Address |
3554 W Glendale Ave Phoenix AZ 85051-8358 |
Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
Practice Telephone | 6022335665 |
Practice Fax Number | 6022335666 |
Mailing Telephone | 7709165028 |
Mailing Fax Number | 6782477858 |
Enumeration Date | 2006-10-03 |
Last Update Date | 2014-12-17 |
Authorized Official Name | DR. DALE MAYFIELD (PRESIDENT) |
Authorized Official Telephone | 7709165028 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
Other Name | Type Code |
---|---|
KOOL SMILES | Doing Business As Name - Organization |
Street Address |
3554 W GLENDALE AVE |
City | PHOENIX |
State | AZ |
Zip Code | 85051-8358 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770927410 | General Dentistry 4 Kids-glendale Pllc | Dentist | 3554 W Glendale Ave, Phoenix, AZ 85051-8358 | 2013-04-24 |
1194856955 | Timothy Manning | Dentist | 3554 W Glendale Ave, Phoenix, AZ 85051-8358 | 2007-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184250383 | Jhajaira Elizabeth Cadenas | Optometrist | 3937 W Northview Ave, Phoenix, AZ 85051 | 2020-03-19 |
1083270854 | Vision With Wings | Voluntary or Charitable | 9617 N. Metro Pkwy West, Ste. 1214, Phoeniz, AZ 85051 | 2019-05-16 |
1417510405 | Applied Behavioral Interventions Pllc | Dietitian, Registered | 10000 N. 31st Avenue Ste. A107, Phoenix, AZ 85051 | 2019-04-16 |
1558832683 | Liberty Home LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9649 N 36th Ave, Phoenix, AZ 85051 | 2018-12-16 |
1518459080 | Addie Robin Diroberts | Counselor | 10240 W. 31st Ave, Phoenix, AZ 85051 | 2018-05-31 |
1093239816 | Jason Allan Parker | Licensed Practical Nurse | 3310 West Cheryl Drive, Phoenix, AZ 85051 | 2017-08-02 |
1588019145 | Vanessa Eloise Hernandez | Counselor | 10000 N. 31st Ave., Applied Behavioral Interventions, Pllc, Phoenix, AZ 85051 | 2016-05-02 |
1912230178 | Mozelle Barr Martin | Counselor | 3734 W. Vista Ave., Phoenix, AZ 85051 | 2009-09-04 |
1316184542 | Tom Sowash Od & Associates PC | Optometrist | 9617 North Parkway West, #1160, Phoenix, AZ 85051 | 2009-01-09 |
1609026913 | Luma Z Sayegh | Dentist | 7012 N 35th Ave, Suite 1, Phoenix, AZ 85051 | 2008-09-23 |
Find all providers in zip 85051 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205441136 | Maryvale Dental Studio | Dentist | 7614 W Indian School Rd # 2, Phoenix, AZ 85033-3035 | 2020-09-08 |
1912516535 | Ford Calaway Dentistry & Orthodontics LLC | Dentist | 2111 E Highland Ave Ste B, Phoenix, AZ 85016-4741 | 2020-07-29 |
1568085637 | Family Dental Phoenix | Dentist | 2401 W Glendale Ave Ste 102, Phoenix, AZ 85021-7621 | 2020-05-24 |
1699308866 | Signature Dental Partners LLC | Dentist | 410 N 44th St Ste 290, Phoenix, AZ 85008-7622 | 2020-02-17 |
1164062618 | Smile Dentistry Pllc | Dentist | 1238 E. Chandler Blvd. #101, Phoenix, AZ 85048 | 2020-01-13 |
1942849146 | Risas O.s. Dental Partners Az LLC | Dentist | 7442 W. Thomas Rd., Phoenix, AZ 85033 | 2020-01-06 |
1831748532 | Benjamin Paul Chalom Baranes | Dentist | 5225 N 19th Ave Ste C, Phoenix, AZ 85015-2903 | 2019-09-05 |
1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
1376101188 | Bethany Helen Armendariz | Dentist | 4757 E Greenway Rd # Set108, Phoenix, AZ 85032-8513 | 2019-06-05 |
1851958300 | Smile Dental Studio | Dentist | 10209 N 35th Ave Ste 129, Phoenix, AZ 85051-9619 | 2019-05-21 |
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.