Dental Depot 91St & Indian School, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC

Practice address

4115 N. 91St Ave.
Phoenix, AZ 85037

Phone

(623) 604-6723

Fax

(480) 741-8850

NPI assigned

May 19, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Glenn A Ashmore

Title

Owner / Ceo

Phone

(405) 945-8941

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1073204012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127404",
            "telephone_number": "405-945-8941",
            "fax_number": "405-945-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 N. 91ST AVE.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85037",
            "telephone_number": "623-604-6723",
            "fax_number": "480-741-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "ASHMORE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "405-945-8941",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denova Collaborative Health, LLC
• Breann Denson
• Kimberly A Dent, PNP
• Lakisha A Dent, AA,BS,MA,PSYD
• Dental and Braces Roosevelt PLLC
• Dental Depot Ortho Greenway PLLC
• Dental Design of Arcadia
• Dental Hearts
• Dental Home Concepts
• Dental Home, LLC

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.