NPIMap

Organization Active NPI

Enhouse Dental LLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1083094205
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D6700 Issued in AZ
Legal business name
ENHOUSE DENTAL LLC
Practice address
4747 E Bell Rd
Suite 7
Phoenix, AZ 85032-2301
Phone
(602) 507-6155
Fax
(602) 507-6155
NPI assigned
Jun 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Authorized official

Name
Miss Holly Marie Kozerski
Title
Practice Administrator
Phone
(602) 266-1776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D6700 AZ Primary

Addresses

Primary practice location

4747 E Bell Rd
Suite 7
Phoenix, AZ 85032-2301

Mailing address

5133 N Central Ave
Suite 200
Phoenix, AZ 85012-1438
Phone (602) 507-6155

Other names 1

  • Dental on Central Tatum Point Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1083094205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5133 N CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121438",
            "telephone_number": "602-507-6155",
            "fax_number": "602-507-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 E BELL RD",
            "address_2": "SUITE 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322301",
            "telephone_number": "602-507-6155",
            "fax_number": "602-507-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHOUSE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "KOZERSKI",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "602-266-1776",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D6700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental on Central Tatum Point",
            "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 Jun 3, 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.