Aesthetic Dental Care of Arizona, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3216 Issued in AZ

Legal business name

AESTHETIC DENTAL CARE OF ARIZONA, P.C.

Practice address

34 Lake Havasu Ave N
Suite 5
Lake Havasu City, AZ 86403-5638

Phone

(928) 453-5577

Fax

(928) 453-1661

NPI assigned

Aug 6, 2007

Last updated

Aug 6, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dee Dennis Moshos, D.D.S.NPI 1669559357

Title

President

Phone

(928) 453-5577

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dee Dennis Moshos Sr., D.D.S.

  • General Practice Dentistry
  • Lake Havasu City, AZ
  • NPI 1669559357
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1003007956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 LAKE HAVASU AVE N",
            "address_2": "SUITE 5",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035638",
            "telephone_number": "928-453-5577",
            "fax_number": "928-453-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 LAKE HAVASU AVE N",
            "address_2": "SUITE 5",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035638",
            "telephone_number": "928-453-5577",
            "fax_number": "928-453-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC DENTAL CARE OF ARIZONA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "MOSHOS",
        "authorized_official_first_name": "DEE",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-453-5577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "3216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.