DR. TINA PTACEK (NPI# 1649403775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649403775 |
| Entity Type | Individual |
| Full Name | DR. TINA PTACEK |
| Credential | DMD |
| Practice Address |
15180 N Cotton Ln Ste 104 Surprise AZ 85388-7000 |
| Mailing Address |
23219 N Del Monte Dr Sun City West AZ 85375-2372 |
| Practice Telephone | 6232146543 |
| Mailing Telephone | 6236286858 |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2020-06-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D7818 | AZ | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
32491 | TX | Dental Providers |
| Street Address |
15180 N COTTON LN STE 104 |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85388-7000 |
| 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 | 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 |
|---|---|---|---|---|
| 1982703427 | Matthew O. Jensen | Dentist | 15331 W Bell Rd Ste 112, Surprise, AZ 85374-4103 | 2006-09-21 |
| 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 |
| 1033750724 | Mesa Valley Dental LLC | Dentist | 1220 S Higley Rd Ste 206, Mesa, AZ 85206-4002 | 2019-10-03 |
| 1942841663 | Mesa Kidtastic Dental LLC | Dentist | 1240 W Southern Ave Ste 112, Mesa, AZ 85202-4882 | 2019-10-03 |
| 1497396170 | Gilbert Kidtastic Dental LLC | Dentist | 3303 E Queen Creek Rd Ste 106, Gilbert, AZ 85297-8532 | 2019-10-03 |
| 1386207785 | Cattron's Dmd, Pllc | Dentist | 4024 E Guadalupe Rd Ste 105, Gilbert, AZ 85234-7672 | 2019-04-21 |
| 1578126470 | Scottsdale Pediatric Dental Associates Inc | Dentist | 9280 E Raintree, Suite 108, Scottsdale, AZ 85260 | 2019-04-16 |
| 1194200980 | Highbury Dental Management, LLC | Dentist | 4425 S Mountain Rd, Suite 109, Mesa, AZ 85212 | 2018-09-27 |
| 1568957199 | Maureen Malingkas | Dentist | 8248 W Deer Valley Rd, Peoria, AZ 85382-2198 | 2018-06-26 |
| 1407344567 | Kids Dental Group Pllc | Dentist | 6239 E Brown Rd Ste 102, Mesa, AZ 85205-4933 | 2018-04-24 |
| 1861989121 | Logan Mariano | Dentist | 4383 E Rosemonte Dr, Phoenix, AZ 85050-3407 | 2018-04-21 |
| 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.