NPIMap

Organization Active NPI

Tricity Dental

  • Dental Clinic/Center
  • Prescott, AZ
National Provider Identifier
1043471493
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D3674 Issued in AZ
Legal business name
TRICITY DENTAL
Practice address
1000 Willow Creek Rd
Suite H
Prescott, AZ 86301-1645
Phone
(928) 445-3181
Fax
(928) 445-5797
NPI assigned
Jun 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Paul Juan Wulff, D.M.DNPI 1790967610
Title
Owner
Phone
(928) 445-3181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D3674 AZ Primary

Addresses

Primary practice location

1000 Willow Creek Rd
Suite H
Prescott, AZ 86301-1645

Mailing address

1000 Willow Creek Rd
Suite H
Prescott, AZ 86301-1645
Phone (928) 445-3181

Other names 1

  • Distinctive Dental Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1043471493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WILLOW CREEK RD",
            "address_2": "SUITE H",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011645",
            "telephone_number": "928-445-3181",
            "fax_number": "928-445-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WILLOW CREEK RD",
            "address_2": "SUITE H",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011645",
            "telephone_number": "928-445-3181",
            "fax_number": "928-445-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WULFF",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-445-3181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "D3674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinctive Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.