Organization Active NPI

Ocotillo Trails Family Dentistry

  • General Practice Dentistry
  • Queen Creek, AZ
National Provider Identifier
1033380316
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OCOTILLO TRAILS FAMILY DENTISTRY
Practice address
40975 N Ironwood Rd
#A102
Queen Creek, AZ 85240-8906
Phone
(480) 457-1977
NPI assigned
Mar 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Dr. Matthew J Scheerhorn, DDS
Title
Co-President
Phone
(480) 358-1675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

40975 N Ironwood Rd
#A102
Queen Creek, AZ 85240-8906

Mailing address

40975 N Ironwood Rd
#A102
Queen Creek, AZ 85240-8906
Phone (480) 457-1977

National Provider Directory

National Provider Directory

Locations

40975 N Ironwood Dr
#A102
Queen Creek, AZ 85140
Phone (480) 457-1977

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1033380316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40975 N IRONWOOD RD",
            "address_2": "#A102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852408906",
            "telephone_number": "480-457-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40975 N IRONWOOD RD",
            "address_2": "#A102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852408906",
            "telephone_number": "480-457-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO TRAILS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "SCHEERHORN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "480-358-1675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.