DNC Holdings LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5540 Issued in AZ

Legal business name

DNC HOLDINGS LLC

Practice address

4244 N 19TH Ave
Phoenix, AZ 85015-5108

Phone

(602) 776-9700

Fax

(602) 776-9699

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dan L Nydegger, D.D.S.

Title

Owner

Phone

(602) 776-9700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tiny Teeth Dental Care Doing business as

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053332262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4244 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155108",
            "telephone_number": "602-776-9700",
            "fax_number": "602-776-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4244 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155108",
            "telephone_number": "602-776-9700",
            "fax_number": "602-776-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DNC HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NYDEGGER",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-776-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "619645",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tiny Teeth Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, 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 22, 2020; 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.