NPIMap

Organization Active NPI

Arizona Dental Anesthesiology PLLC

  • Dentist
  • Gilbert, AZ
National Provider Identifier
1073875712
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7656 Issued in AZ
Legal business name
ARIZONA DENTAL ANESTHESIOLOGY PLLC
Practice address
817 E San Angelo Ave
Gilbert, AZ 85234-3513
Phone
(480) 678-9724
NPI assigned
Jun 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Authorized official

Name
Sonia Kumar, DDS
Title
Dentist Anesthesiologist
Phone
(480) 678-9724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7656 AZ Primary

Addresses

Primary practice location

817 E San Angelo Ave
Gilbert, AZ 85234-3513

Mailing address

817 E San Angelo Ave
Gilbert, AZ 85234-3513

Other identifiers 1

IdentifierTypeStateIssuer
381017MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1073875712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 E SAN ANGELO AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 E SAN ANGELO AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343513",
            "telephone_number": "480-678-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL ANESTHESIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "DENTIST ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "480-678-9724",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "7656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381017",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.