NPIMap

Organization Active NPI

South Mesa Dental Partners

Doing business as Comfort Dental West Mesa

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1053693531
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D008299 Issued in AZ
Legal business name
SOUTH MESA DENTAL PARTNERS
Doing business as
Comfort Dental West Mesa
South Mesa Dental Partners
Practice address
1130 S. Country Club Dr
Ste 101
Mesa, AZ 85210-4639
Phone
(480) 461-9866
Fax
(480) 461-9861
NPI assigned
Sep 12, 2011
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Dr. Tad Brandon Olsen, DMDNPI 1144756016
Title
Owner
Phone
(480) 461-9866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D008299 AZ Primary

Addresses

Primary practice location

1130 S. Country Club Dr
Ste 101
Mesa, AZ 85210-4639

Mailing address

1130 S. Country Club Dr
Ste 101
Mesa, AZ 85210-4639
Phone (480) 461-9866

Other names 2

  • Comfort Dental West Mesa Doing business as
  • South Mesa Dental Partners Doing business as

National Provider Directory

National Provider Directory

Locations

1130 S Country Club Dr
Ste 101
Mesa, AZ 85210
Phone (480) 461-9866

1130 S Country Club Dr
Unit 101
Mesa, AZ 85210
Phone (480) 833-9866

Practitioners & affiliated clinicians

Practitioners 2

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": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1053693531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S. COUNTRY CLUB DR",
            "address_2": "STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104639",
            "telephone_number": "480-461-9866",
            "fax_number": "480-461-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S. COUNTRY CLUB DR",
            "address_2": "STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104639",
            "telephone_number": "480-461-9866",
            "fax_number": "480-461-9861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MESA DENTAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-12",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "TAD",
        "authorized_official_middle_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-461-9866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Dental West Mesa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Mesa Dental Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.