Parker Dental Center LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PARKER DENTAL CENTER LLC

Practice address

155 W Riverside Dr
Parker, AZ 85344-5221

Phone

(928) 669-0099

NPI assigned

Mar 21, 2022

Last updated

Mar 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tera Niedens

Title

Accountant

Phone

(623) 289-2616

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammad Walid Omary, DDS

  • General Practice Dentistry
  • Parker, AZ
  • NPI 1306458740
  NPD
• Ilan Shamos, DMD

  • Dentist
  • Parker, AZ
  • NPI 1851731046
  NPD (past)

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1093464711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34225 N 27TH DR STE 241",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856091",
            "telephone_number": "623-289-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W RIVERSIDE DR",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853445221",
            "telephone_number": "928-669-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKER DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "NIEDENS",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "623-289-2616"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Parker",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "155 W Riverside Dr",
            "city": "Parker",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853445221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mohammad Walid Omary, DDS
• Cody Ray Paddock
• Staci Ann Page, PA-C
• Roland Allen Palmquist, DPM
• Parker Community Senior Center
• Parker Emergency Services LLC
• Parker Family Dental
• Parker Family Practice PLLC
• Parker Indain Healthcare Center
• Parker Indian Health Center

• Dental Clinic/Center in Parker, AZ
• Providers in Parker, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.