NPIMap

Organization Active NPI

C and E Dental Professionals

Doing business as Phoenix Family Dentistry

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1063976488
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
C AND E DENTAL PROFESSIONALS
Doing business as
Phoenix Family Dentistry
Practice address
13821 N 35TH Dr Ste 2
Phoenix, AZ 85053-5541
Phone
(602) 547-9007
NPI assigned
Jan 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Deborah Bonnet
Title
Operations Manager
Phone
(602) 882-0676

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

13821 N 35TH Dr Ste 2
Phoenix, AZ 85053-5541

Mailing address

13821 N 35TH Dr Ste 2
Phoenix, AZ 85053-5541
Phone (602) 547-9007

Other practice location 1

12020 N 35th Ave Ste 112
Phoenix, AZ 85029-3213
Phone (602) 547-9007

Other names 1

  • Phoenix Family Dentistry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260121001404 AZ DME Supplier - Oral Surgery - Dentist 1850878802 Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory
Tax ID family
C and E Dental Professionals2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

12020 N 35th Ave
Ste 112
Phoenix, AZ 85029
Phone (602) 547-9007

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1063976488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13821 N 35TH DR STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850535541",
            "telephone_number": "602-547-9007",
            "fax_number": "602-547-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13821 N 35TH DR STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850535541",
            "telephone_number": "602-547-9007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12020 N 35th Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850293213",
            "country_code": "US",
            "telephone_number": "602-547-9007",
            "fax_number": "602-547-3438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "C AND E DENTAL PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "BONNET",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "602-882-0676"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.