Organization Active NPI

Prime Dental Care, LLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1003038621
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AZ2025 Issued in AZ
Legal business name
PRIME DENTAL CARE, LLC
Practice address
5030 West Baseline Road
Phoenix, AZ 85339-7331
Phone
(602) 237-8880
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dean H Walker, DDS
Title
Partner
Phone
(602) 237-8880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X AZ2025 AZ Primary

Addresses

Primary practice location

5030 West Baseline Road
Phoenix, AZ 85339-7331

Mailing address

5030 West Baseline Road
Phoenix, AZ 85339-7331
Phone (602) 237-8880

National Provider Directory

National Provider Directory

Locations

5030 W Baseline Rd
Laveen, AZ 85339
Phone (602) 237-8880

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003038621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 WEST BASELINE ROAD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "853397331",
            "telephone_number": "602-237-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 WEST BASELINE ROAD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "853397331",
            "telephone_number": "602-237-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "602-237-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "AZ2025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.