NPIMap

Organization Active NPI

SV Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Mesa, AZ
National Provider Identifier
1083086920
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SV PEDIATRIC DENTISTRY, LLC
Practice address
1220 S Higley Rd
Suite #206
Mesa, AZ 85206-4000
Phone
(480) 985-9110
Fax
(480) 924-5709
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Authorized official

Name
John E Ballard
Title
Cfo, Cio
Phone
(480) 889-9457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1220 S Higley Rd
Suite #206
Mesa, AZ 85206-4000

Mailing address

4435 E Holmes Ave
Mesa, AZ 85206-3372
Phone (480) 889-9457

Other names 1

  • Sun Valley Pediatric Dentistry Mesa Doing business as

National Provider Directory

National Provider Directory

Locations

4435 E Holmes Ave
Mesa, AZ 85206

1220 S Higley Rd
Ste 206
Mesa, AZ 85206
Phone (480) 985-9110

Practitioners & affiliated clinicians

Practitioners 3

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": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1083086920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 E HOLMES AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063372",
            "telephone_number": "480-889-9457",
            "fax_number": "480-696-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S HIGLEY RD",
            "address_2": "SUITE #206",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064000",
            "telephone_number": "480-985-9110",
            "fax_number": "480-924-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SV PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO, CIO",
        "authorized_official_telephone_number": "480-889-9457"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Valley Pediatric Dentistry Mesa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.