NPIMap

Organization Active NPI

Az Specialty Dental Services, LLC

Doing business as Redstone Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Peoria, AZ
National Provider Identifier
1053136663
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
AZ SPECIALTY DENTAL SERVICES, LLC
Doing business as
Redstone Orthodontics
Practice address
10006 W Happy Valley Pkwy Ste 12
Peoria, AZ 85383-1235
Phone
(623) 486-3377
NPI assigned
Nov 19, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
AZ SPECIALTY DENTAL SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Charlotte V Dasch
Title
Director of Cred and Prov Rel
Phone
(504) 638-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X Primary

Addresses

Primary practice location

10006 W Happy Valley Pkwy Ste 12
Peoria, AZ 85383-1235

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (615) 678-0759

Other practice location 1

754 S Val Vista Dr Ste 107
Gilbert, AZ 85296-3158
Phone (480) 892-6200

Other names 1

  • Redstone Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Az Specialty Dental Services LLC12 organizations share this tax ID, including this one
Part of
Az Specialty Dental Services LLC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

754 S Val Vista Dr
Ste 107
Gilbert, AZ 85296
Phone (480) 892-6200

10006 W Happy Valley Pkwy
Ste 12
Peoria, AZ 85383
Phone (623) 486-3377

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1053136663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10006 W HAPPY VALLEY PKWY STE 12",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831235",
            "telephone_number": "623-486-3377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "754 S Val Vista Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852963158",
            "country_code": "US",
            "telephone_number": "480-892-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AZ SPECIALTY DENTAL SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AZ SPECIALTY DENTAL SERVICES, LLC",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIRECTOR OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redstone Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.