Organization Active NPI

San Marcos Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chandler, AZ
National Provider Identifier
1093817421
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D4690 Issued in AZ
Legal business name
SAN MARCOS ORTHODONTICS PLLC
Doing business as
Serrano & Kyger Orthodontics
Practice address
800 W. Chandler Blvd
Ste 5
Chandler, AZ 85225-2508
Phone
(480) 899-1633
Fax
(480) 786-3647
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
A Paul Serrano, DDS
Title
Officer Owner
Phone
(480) 899-1633

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X D2814 AZ
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X D4690 AZ Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

800 W. Chandler Blvd
Ste 5
Chandler, AZ 85225-2508

Mailing address

800 W. Chandler Blvd
Ste 5
Chandler, AZ 85225-2508
Phone (480) 899-1633

Other names 1

  • Serrano & Kyger Orthodontics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1093817421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W. CHANDLER BLVD",
            "address_2": "STE 5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252508",
            "telephone_number": "480-899-1633",
            "fax_number": "480-786-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W. CHANDLER BLVD",
            "address_2": "STE 5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252508",
            "telephone_number": "480-899-1633",
            "fax_number": "480-786-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MARCOS ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "A",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OFFICER  OWNER",
        "authorized_official_telephone_number": "480-899-1633",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D2814",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D4690",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serrano & Kyger Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.