RIDGE DENTAL SPECIALISTS LLC (NPI# 1689895765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689895765 |
| Entity Type | Organization |
| Organization Name | RIDGE DENTAL SPECIALISTS LLC |
| Other Organization Name | CANYON RIDGE ENDODONTICS |
| Practice Address |
20950 N Tatum Blvd Suite 210 Phoenix AZ 85050 |
| Practice Telephone | 4805388100 |
| Practice Fax Number | 4805388101 |
| Mailing Telephone | 4805388100 |
| Mailing Fax Number | 4805388101 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS PAUL LAMMOT (PRESIDENT ENDODONTIST) |
| Authorized Official Telephone | 4805388100 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
D6278 | AZ | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
D6932 | AZ | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D6338 | AZ | Dental Providers |
| Other Name | Type Code |
|---|---|
| Canyon Ridge Endodontics | Other Name - Individual/Organization |
| Street Address |
20950 N TATUM BLVD SUITE 210 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982604708 | Steven Cary Simon | Surgery | 20950 N Tatum Blvd, Suite 308, Phoenix, AZ 85050-4200 | 2005-07-22 |
| 1689110314 | Trusted Care Surgery Centers LLC | Clinic/Center | 20950 N Tatum Blvd, Suite 170, Phoenix, AZ 85050-4200 | 2017-01-19 |
| 1790141224 | Cheryl Schaaf | Registered Nurse | 20950 N Tatum Blvd, Suite 150, Phoenix, AZ 85050-4200 | 2016-01-13 |
| 1659749190 | Micheal Papademetriou | Dentist | 20950 N Tatum Blvd, 370, Phoenix, AZ 85050-4200 | 2015-09-14 |
| 1124427828 | Derrick A. Debenedetto | Physical Therapist | 20950 N Tatum Blvd, Ste. 100, Phoenix, AZ 85050-4200 | 2014-08-19 |
| 1770997413 | Kaitlyn Kakar | Physical Therapist | 20950 N Tatum Blvd, Suite 100, Phoenix, AZ 85050-4200 | 2014-06-19 |
| 1568874683 | Az Pain Consultants LLC | Pain Medicine | 20950 N Tatum Blvd, Suite 220, Phoenix, AZ 85050-4200 | 2014-05-22 |
| 1215363320 | Desert Ridge Oral,facial & Implant Surgery, Pllc | Dentist | 20950 N Tatum Blvd, Suite 120, Phoenix, AZ 85050-4200 | 2013-09-20 |
| 1427490242 | Lauren K. Hasquet | Physical Therapist | 20950 N Tatum Blvd, Suite 100, Phoenix, AZ 85050-4200 | 2013-07-22 |
| 1588960512 | Desert Ridge Implant & Oral Surgery PC | Dentist | 20950 N Tatum Blvd, Ste. 120, Phoenix, AZ 85050-4200 | 2011-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045528 | Jesse Micheal Stokke | Student in an Organized Health Care Education/Training Program | Honorhealth Jomax Clinic, 26224 N. Tatum Blvd. #5, Phoenix, AZ 85050 | 2019-04-02 |
| 1386104974 | Dania Aijaz Shah | Student in an Organized Health Care Education/Training Program | Honor Health Jomax Clinic, 26224 N. Tatum Blvd. #5, Phoenix, AZ 85050 | 2019-03-21 |
| 1205391588 | Sanctuary | Clinic/Center | 2550 E Rose Garden Ln, # 73404, Phoenix, AZ 85050 | 2019-01-31 |
| 1477026474 | Archer Health LLC | Nurse Practitioner | 21001 N Tatum Blvd Ste 1630 - 490, Phoenix, AZ 85050 | 2019-01-02 |
| 1548756059 | Preston Andrew Slade | Community/Behavioral Health | 20860 E. Tatum Blvd Ste, 300, Phoenix, AZ 85050 | 2018-07-09 |
| 1184126658 | Alisha Ramirez | Specialist/Technologist | 19638 N 37th Way, Phoenix, AZ 85050 | 2018-03-01 |
| 1720590011 | Dr Richards Pllc | Internal Medicine | 20815 N 25th Pl Ste A106, Phoenix, AZ 85050 | 2017-10-26 |
| 1417474792 | Heather Arabeity | Nurse Practitioner | 3762 E Zachary Dr, Phoenix, AZ 85050 | 2017-08-28 |
| 1083161087 | Haley Elaine Kinzer | Physician Assistant | 20950 N Tatum Blvd Ste 150, Phoenix, AZ 85050 | 2016-09-07 |
| 1003227927 | Chelsea Joy Thomsen | Internal Medicine | 26224 N Tatum Blvd Ste 7, Phoenix, AZ 85050 | 2014-05-13 |
| Find all providers in zip 85050 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083005136 | Baseline Dental, PC | Dentist | 2030 W Baseline Rd Ste 176, Phoenix, AZ 85041-6574 | 2015-02-11 |
| 1457767758 | Brandi L. Molina | Dentist | 702 E Bell Rd Ste 111, Phoenix, AZ 85022-6639 | 2014-07-08 |
| 1730496514 | Carl R Wright | Dentist | 15215 S 48th St Ste 136, Phoenix, AZ 85044-9138 | 2010-09-01 |
| 1891982443 | Emad Gus Khalifa | Dentist | 20950 N Tatum Blvd Ste 210, Phoenix, AZ 85050-4268 | 2007-09-27 |
| 1558567743 | Percy B. Twine | Dentist | 2020 W Baseline Rd Ste 172, Phoenix, AZ 85041-6573 | 2007-06-25 |
| 1972713493 | Eugene Salazar | Dentist | 706 E Bell Rd Ste 104, Phoenix, AZ 85022 | 2007-05-23 |
| 1831294032 | Kevin T Axx | Dentist | 4141 N 32nd St Ste 100, Phoenix, AZ 85018-4775 | 2006-09-13 |
| 1700811692 | Jacqueline Savannah Allen | Dentist | 6520 N 7th Ave, Suite 7, Phoenix, AZ 85013-1173 | 2006-07-11 |
| 1659308641 | North Valley Endodontics, P.a. | Dentist | 706 E Bell Road, Suite 106, Phoenix, AZ 85022-6640 | 2006-06-27 |
| 1427004654 | Victor A Palmieri | Dentist | 2737 E Brookwood Ct, Phoenix, AZ 85048-9359 | 2006-05-26 |
| 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.