Horizon Dental Group Spring Valley

Primary specialty

DentistTaxonomy code 122300000X

License

D5634 Issued in AZ

Legal business name

HORIZON DENTAL GROUP SPRING VALLEY

Practice address

17301 E Spring Valley Rd Ste C
Spring Valley, AZ 86333-4263

Phone

(928) 632-9099

Fax

(928) 458-7090

NPI assigned

Sep 7, 2016

Last updated

Sep 7, 2016By 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

Dr. Mark Anthony Costes, DDSNPI 1932399680

Title

Owner

Phone

(928) 925-6522

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Mark A Costes, D.D.S.

  • General Practice Dentistry
  • Chino Valley, AZ
  • NPI 1932399680
  NPD (past) Authorized official

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1063969046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17301 E SPRING VALLEY RD STE C",
            "city": "SPRING VALLEY",
            "state": "AZ",
            "postal_code": "863334263",
            "telephone_number": "928-632-9099",
            "fax_number": "928-458-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17301 E SPRING VALLEY RD STE C",
            "city": "SPRING VALLEY",
            "state": "AZ",
            "postal_code": "863334263",
            "telephone_number": "928-632-9099",
            "fax_number": "928-458-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON DENTAL GROUP SPRING VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "COSTES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-925-6522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "703042",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "731456",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Black Canyon Medical (Bradshaw Mountain Family Medicine)
• Sandra D. Coco, M.A., CCC-A
• Douglas Kendall Conley, FNP
• Emily Lyford, M.A.
• New Day Rising
• Emily Catherine Norman, NP
• Spring Ridge Academy
• Kimberly Ann Whitehill, FNP

• Dentist in Spring Valley, AZ
• Providers in Spring Valley, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.