NPIMap

Organization Active NPI

Impressions Dental

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1033398870
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6572 Issued in AZ
Legal business name
IMPRESSIONS DENTAL
Practice address
5970 S Cooper Rd
Ste 1
Chandler, AZ 85249-5393
Phone
(480) 814-8888
Fax
(480) 814-1553
NPI assigned
Oct 29, 2007
Last updated
Oct 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Dr. Kelly Wettstein, DMDNPI 1285739078
Title
Owner
Phone
(480) 814-8888

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
General Practice Dentistry 1223G0001X 6572 AZ Primary

Addresses

Primary practice location

5970 S Cooper Rd
Ste 1
Chandler, AZ 85249-5393

Mailing address

5970 S Cooper Rd
Ste 1
Chandler, AZ 85249-5393
Phone (480) 814-8888

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1033398870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 S COOPER RD",
            "address_2": "STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495393",
            "telephone_number": "480-814-8888",
            "fax_number": "480-814-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 S COOPER RD",
            "address_2": "STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495393",
            "telephone_number": "480-814-8888",
            "fax_number": "480-814-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPRESSIONS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "WETTSTEIN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-814-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.