Dental Specialty Group Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

DENTAL SPECIALTY GROUP INC

Practice address

4435 E Broadway Rd Ste 7
Mesa, AZ 85206-2012

Phone

(480) 471-8480

Fax

(480) 654-0705

NPI assigned

Feb 19, 2021

Last updated

Feb 26, 2021By 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

Bennett Mankin

Title

President

Phone

(480) 239-2088

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1063005049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3658 E MORRISON RANCH PKWY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961816",
            "telephone_number": "480-239-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 E BROADWAY RD STE 7",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062012",
            "telephone_number": "480-471-8480",
            "fax_number": "480-654-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALTY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "MANKIN",
        "authorized_official_first_name": "BENNETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-239-2088"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Innovations
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• Dental One, Inc.
• Dental One, Inc. (Desert Family Dental)
• Dental Progressions PLLC
• Dentistry for Children PLLC
• Dentistry Group Foundation, LLC (Valleywide Sunshine Dental Care)
• Dentists of Mesa, LLP (Dentists of Mesa)
• Dentists of North Mesa, LLP
• Sharla Denton, BHP

• Periodontics in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.