NPIMap

Organization Active NPI

Highbury Dental Management, LLC

  • Pediatric Dentistry
  • Phoenix, AZ
National Provider Identifier
1063950681
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
HIGHBURY DENTAL MANAGEMENT, LLC
Practice address
4244 N 19TH Ave
Phoenix, AZ 85015-5108
Phone
(602) 776-9700
NPI assigned
Feb 2, 2017
Last updated
Feb 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Authorized official

Name
Richard Rowan
Title
Owner
Phone
(505) 892-9010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4244 N 19TH Ave
Phoenix, AZ 85015-5108

Mailing address

9201 Eagle Ranch Rd NW
Albuquerque, NM 87114-6032

National Provider Directory

National Provider Directory
Tax ID family
Highbury Dental Management LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1063950681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 EAGLE RANCH RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871146032"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHBURY DENTAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "ROWAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-892-9010"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.