CENTER FOR PEDIATRIC DENTISTRY, L.L.C. (NPI# 1689875791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689875791 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PEDIATRIC DENTISTRY, L.L.C. |
| Practice Address |
2571 S Val Vista Dr Ste 101 Gilbert AZ 85295-6233 |
| Practice Telephone | 4805975536 |
| Practice Fax Number | 4805975624 |
| Mailing Telephone | 4805975536 |
| Mailing Fax Number | 4805975624 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | KARLA ABDOLL (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 4805975536 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID # | 590291 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2900 W Ray Rd, Ste# 2, Chandler, AZ 852247342 | 4807825437 | 4808577888 |
| Street Address |
2571 S VAL VISTA DR STE 101 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85295-6233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225074040 | Rassa Abdollahzadeh | Dentist | 2571 S Val Vista Dr Ste 101, Gilbert, AZ 85295-6233 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471368 | Lifequest Holding Company Gilbert, LLC | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd Suite 101, Gilbert, AZ 85295 | 2020-09-09 |
| 1255946075 | Lifequest Physical Medicine and Rehab | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd. Suite 101, Gilbert, AZ 85295 | 2020-09-09 |
| 1407467962 | Lifequest Physical Medicine and Rehab | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd, Suite 101, Gilbert, AZ 85295 | 2020-08-10 |
| 1275187718 | Guylene Lucien | Nurse Practitioner | 1689 S. Parkcrest Street, Gilbert, AZ 85295 | 2019-08-01 |
| 1326607144 | Hand Up Behavioral Services, LLC | Community/Behavioral Health | 4145 East Megan Street, Gilbert, AZ 85295 | 2019-06-06 |
| 1629582069 | Victoria Munoz Garcia | Naturopath | 920 S Williams Field Rd., Ste 102, Gilbert, AZ 85295 | 2017-11-21 |
| 1649798752 | Eureka Imperial Residence | Clinic/Center | 633 E Ray Road, Gilbert, AZ 85295 | 2017-09-08 |
| 1447791496 | Janine Patrice Faux | Counselor | 2563 S. Val Vista Drive St. 108, Gilbert, AZ 85295 | 2017-03-10 |
| 1437690450 | Erskine & Barber LLC | Clinic/Center | 5656 S. Power Rd #129, Gilbert, AZ 85295 | 2017-03-09 |
| 1164965448 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 774 E. Buffalo St, Chandler, AZ 85295 | 2016-11-18 |
| Find all providers in zip 85295 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1487158473 | Jared Benjamin Tinker | Dentist | 3592 S Atherton Blvd Ste 107, Gilbert, AZ 85297-7444 | 2018-03-22 |
| 1184167447 | John E. Culp, IIi Dmd, PC | Dentist | 2080 E Williams Field Rd, Suite #104, Gilbert, AZ 85295-0702 | 2016-11-18 |
| 1871950071 | Joseph Creech | Dentist | 2550 E Guadalupe Rd Ste 101, Gilbert, AZ 85234-5114 | 2016-01-20 |
| 1073895629 | Kidiatric Dentistry, Pllc | Dentist | 913 E Warner Rd, Gilbert, AZ 85296-3078 | 2011-09-09 |
| 1861663635 | Gavin Cotant Christensen | Dentist | 3303 E Queen Creek Rd, Suite 106, Gilbert, AZ 85297-8532 | 2008-03-19 |
| 1285753574 | Timothy J Bashara | Dentist | 5656 S. Power Rd., Ste. 118, Gilbert, AZ 85295 | 2007-03-28 |
| 1780749333 | Abc Dentistry for Children | Dentist | 2363 E Baseline Rd, Gilbert, AZ 85234-2357 | 2006-12-26 |
| 1053488650 | Jared Weston Welch | Dentist | 3011 S Lindsay Rd Ste 108, Gilbert, AZ 85296-0702 | 2006-11-29 |
| Find all providers in GILBERT | ||||
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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.