Dentistry at 35TH Avenu

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D008280 Issued in AZ

Legal business name

DENTISTRY AT 35TH AVENU

Practice address

18635 N 35TH Avenue
Phoenix, AZ 85027

Phone

(623) 581-5532

Fax

(623) 236-9360

NPI assigned

Nov 2, 2013

Organization subpart

No

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

Authorized official

Name

John Van, DDS

Title

Owner

Phone

(623) 581-5532

Specialties & licenses 1

Addresses

Other names 1

• DBA Floss Dental Doing business as

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1013346857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18635 N 35TH AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85027",
            "telephone_number": "623-581-5532",
            "fax_number": "623-236-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18635 N 35TH AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85027",
            "telephone_number": "623-581-5532",
            "fax_number": "623-236-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY AT 35TH AVENU",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "VAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-581-5532",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Floss Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentists of Paradise Valley, LLP
• Dentists of Phoenix, LLP
• Denton Davenport DO, PLLC

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, 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 Nov 2, 2013; 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.