16TH Street Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7288 Issued in AZ

Legal business name

16TH STREET DENTAL CARE

Practice address

1325 W 16TH St
Suite 4
Yuma, AZ 85364-4496

Phone

(928) 782-3839

Fax

(928) 329-9029

NPI assigned

Aug 13, 2008

Last updated

Aug 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carrie Freeze

Title

Office Manager

Phone

(928) 782-3839

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1043466782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 W 16TH ST",
            "address_2": "SUITE 4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644496",
            "telephone_number": "928-782-3839",
            "fax_number": "928-329-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W 16TH ST",
            "address_2": "SUITE 4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644496",
            "telephone_number": "928-782-3839",
            "fax_number": "928-329-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "16TH STREET DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "FREEZE",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-782-3839"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Yuma, AZ
• Providers in Yuma, 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 Aug 13, 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.