DESIRAE DENTAL SERVICES, PLLC (NPI# 1588942494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588942494 |
| Entity Type | Organization |
| Organization Name | DESIRAE DENTAL SERVICES, PLLC |
| Other Organization Name | EXCEPTIONAL DENTISTRY |
| Practice Address |
2872 Jamaica Blvd S Lake Havasu City AZ 86406-7707 |
| Practice Telephone | 9286807645 |
| Practice Fax Number | 9286809466 |
| Mailing Telephone | 9286807645 |
| Mailing Fax Number | 9286809466 |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |
| Authorized Official Name | STERLING DECKER (PRESIDENT) |
| Authorized Official Telephone | 9288146670 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | Dental Providers |
| Other Name | Type Code |
|---|---|
| Exceptional Dentistry | Doing Business As Name - Organization |
| Street Address |
2872 JAMAICA BLVD S |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86406-7707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962056572 | Parker Dental | Clinic/Center | 2872 Jamaica Blvd S, Lake Havasu City, AZ 86406-7707 | 2019-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924070 | James Richard Fisher | Durable Medical Equipment & Medical Supplies | 2540 Viejo Dr, Lake Havasu City, AZ 86406 | 2008-02-27 |
| 1265657969 | Eugene Vitvitsky Md | Surgery | 2046 Burke Lane, Lake Havasu City, AZ 86406 | 2007-04-16 |
| 1659497105 | Assisted Living Concepts Inc | Assisted Living Facility | 3076 Shoshone Drive, Lake Havasu, AZ 86406 | 2007-03-22 |
| 1164546750 | Charles Reese Mead | Dentist | 101 Riveria Dr, Lake Havasu, AZ 86406 | 2007-03-19 |
| 1427172550 | Jesdeen Lynn Nunez | Registered Nurse | 12033 Agency Road, Parker, AZ 86406 | 2007-03-16 |
| 1285797993 | Karen Ann Powell | Podiatrist | Oro Grande Elementary 1250 Pawnee Drive, Lake Havasu City, AZ 86406 | 2006-12-18 |
| 1215978606 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2800 Sweetwater Ave, Lake Havasu City, AZ 86406 | 2006-06-09 |
| 1467519512 | Catherine Evelyn Sondrol | Occupational Therapist | 3588 Tarpon Dr, Lake Havasu City, AZ 86406-4223 | 2007-01-01 |
| 1346477593 | Steven Bertovich | Registered Nurse | 3499 Tarpon Dr, Lake Havasu City, AZ 86406-4246 | 2009-06-15 |
| 1093975310 | Serenity Assisted Living | Assisted Living Facility | 3677 Blue Colt Dr, Lake Havasu City, AZ 86406-4273 | 2008-06-10 |
| Find all providers in zip 86406 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407237852 | Afton Clouse | Dental Assistant | 1200 W Warner Rd Ste 3, Chandler, AZ 85224-2758 | 2015-06-11 |
| 1902290786 | Terry C Ramsey, Dds | Dental Assistant | 9280 E Raintree Dr, Suite 108, Scottsdale, AZ 85260-7588 | 2015-03-19 |
| 1861824351 | Dbbie Arnold | Dental Assistant | 10620 N 43rd Ave, Glendale, AZ 85304-4150 | 2013-08-06 |
| 1740599158 | Ui Son Brown | Dental Assistant | 1100 E Osborn Rd, # 135, Phoenix, AZ 85014-5202 | 2010-10-03 |
| 1770106106 | Jennifer Mclaurin | Dental Assistant | 8535 E Hartford Dr Ste 100, Scottsdale, AZ 85255-5443 | 2020-05-20 |
| 1851806970 | Tanya Hutchison | Dental Assistant | 5415 Distinction Way, Prescott, AZ 86301-8438 | 2017-12-12 |
| 1356791024 | Rashamel Smart | Dental Assistant | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-06-14 |
| 1841650488 | Peggy Susan Stansbury | Dental Assistant | 4025 W Bell Rd, Suite 9, Phoenix, AZ 85053-2750 | 2016-02-24 |
| 1538528922 | North Valley Center for Oral and Implant Surgery | Dental Assistant | 4025 W Bell Rd, Phoenix, AZ 85053-2750 | 2016-02-15 |
| 1417342403 | Charlena Moses | Dental Assistant | 9280 E Raintree Dr, Suite 108, Scottsdale, AZ 85260-7588 | 2015-04-06 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86406 |
Please comment or provide details below to improve the information on DESIRAE DENTAL SERVICES, PLLC.
| 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.