Preventative Dental Care PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PREVENTATIVE DENTAL CARE PLLC

Practice address

19251 E Oasis Dr
Black Canyon City, AZ 85324-8878

Phone

(162) 344-4232

NPI assigned

Aug 27, 2018

Organization subpart

No

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

Authorized official

Name

Scott W Hirsbrunner, DMD

Title

Owner

Phone

(623) 444-2322

Specialties & licenses 1

Addresses

Other names 1

• Canyon Dental Doing business as

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535328000000",
    "number": "1033690169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19251 E OASIS DR",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853248878",
            "telephone_number": "162-344-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 E OASIS DR",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853248878",
            "telephone_number": "162-344-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTATIVE DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A",
        "authorized_official_last_name": "HIRSBRUNNER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-444-2322",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Cheol-Hong Kim, D.O.
• Elli Klinger
• Kevin Carl Krause
• Matthew Lynn McElroy, PA-C
• Gregg Wesley Potter, PT, MPT
• Radiant Dental LLC
• Andja I Rawlings

• Dental Clinic/Center in Black Canyon City, AZ
• Providers in Black Canyon City, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.