Purely Dental Surgery LLC

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

Organization subpart

No

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

Authorized official

Name

Brent L Woodmansee, DMD

Title

Managing Partner

Phone

(602) 799-2251

Specialties & licenses 1

Addresses

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": []
}

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• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• 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.