NPIMap

Organization Active NPI

Purely Dental Surgery LLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1003479882
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PURELY DENTAL SURGERY LLC
Practice address
12320 N 32ND St Ste 2
Phoenix, AZ 85032-7154
Phone
(602) 354-5356
NPI assigned
Apr 17, 2019
Last updated
Apr 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Authorized official

Name
Brent L Woodmansee, DMDNPI 1730454158
Title
Managing Partner
Phone
(602) 799-2251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

12320 N 32ND St Ste 2
Phoenix, AZ 85032-7154

Mailing address

12320 N 32ND St Ste 2
Phoenix, AZ 85032-7154
Phone (602) 354-5356

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1003479882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12320 N 32ND ST STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327154",
            "telephone_number": "602-354-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12320 N 32ND ST STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327154",
            "telephone_number": "602-354-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURELY DENTAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "WOODMANSEE",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "602-799-2251",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "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 Apr 17, 2019; 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.