DESERT RIDGE PEDIATRIC DENTISTRY (NPI# 1811176860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811176860 |
| Entity Type | Organization |
| Organization Name | DESERT RIDGE PEDIATRIC DENTISTRY |
| Practice Address |
5315 E. High Street Suite 115 Phoenix AZ 85054 |
| Mailing Address |
5315 E High St Suite 115 Phoenix AZ 85054-5438 |
| Practice Telephone | 4805855868 |
| Practice Fax Number | 4805851208 |
| Mailing Telephone | 4805855868 |
| Mailing Fax Number | 4805851208 |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2015-07-17 |
| Authorized Official Name | DR. LIDIETH R LIBBY (OWNER) |
| Authorized Official Telephone | 4805855868 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5548 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 632481 | 05 |
| Street Address |
5315 E. HIGH STREET SUITE 115 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| 1740283878 | Charles J Manak | Internal Medicine | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2005-05-23 |
| Find all providers in zip 85054 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946257 | Tatum Point Dentistry LLC | Clinic/Center | 4747 E Bell Rd Ste 15, Phoenix, AZ 85032-2301 | 2020-09-15 |
| 1003421009 | Solterra Dentistry LLC | Clinic/Center | 15255 N 40th St Ste 111, Phoenix, AZ 85032-4636 | 2020-09-15 |
| 1336751536 | Smile Nuvo | Clinic/Center | 2142 W Red Fox Rd, Phoenix, AZ 85085-5458 | 2020-08-19 |
| 1942821301 | Family and Kids Dental LLC | Clinic/Center | 2610 W Baseline Rd Ste 120, Phoenix, AZ 85041-6400 | 2020-04-27 |
| 1003458688 | Uptown Pediatric Dental Group, Pllc | Clinic/Center | 1515 E Missouri Ave Ste 103, Phoenix, AZ 85014-2443 | 2019-10-15 |
| 1538720818 | Scott A. Simpson Dds Pllc | Clinic/Center | 14231 N 7th St Ste A14231n7, Phoenix, AZ 85022-4360 | 2019-06-26 |
| 1992362891 | Lemon Tree Dentistry LLC | Clinic/Center | 1985 W Happy Valley Rd Ste 115, Phoenix, AZ 85085-2888 | 2019-05-26 |
| 1457813768 | Singh Smile Care | Clinic/Center | 3201 W Peoria Ave Ste A103, Phoenix, AZ 85029-4609 | 2019-04-04 |
| 1710447370 | Minted Dental | Clinic/Center | 21050 N Tatum Blvd Ste 200, Phoenix, AZ 85050-4262 | 2019-03-20 |
| 1679032197 | Denkha Dentistry, LLC | Clinic/Center | 1601 E Bell Rd Ste A13, Phoenix, AZ 85022-6254 | 2019-03-14 |
| 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.