NPIMap

Organization Active NPI

Flagstaff Dental Group, PLLC

  • Dentist
  • Flagstaff, AZ
National Provider Identifier
1104049089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2792 Issued in AZ
Legal business name
FLAGSTAFF DENTAL GROUP, PLLC
Practice address
10 W Hunt Ave
Flagstaff, AZ 86001-3018
Phone
(928) 774-1481
Fax
(928) 214-9388
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Leslie D Seaman, D.D.S.NPI 1285850115
Title
Partner
Phone
(928) 774-1481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2792 AZ Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5855 AZ
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5906 AZ

Addresses

Primary practice location

10 W Hunt Ave
Flagstaff, AZ 86001-3018

Mailing address

10 W Hunt Ave
Flagstaff, AZ 86001-3018
Phone (928) 774-1481

National Provider Directory

National Provider Directory

Locations

10 W Hunt Ave
Flagstaff, AZ 86001
Phone (928) 774-1481

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104049089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W HUNT AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013018",
            "telephone_number": "928-774-1481",
            "fax_number": "928-214-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W HUNT AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013018",
            "telephone_number": "928-774-1481",
            "fax_number": "928-214-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEAMAN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "928-774-1481",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "2792",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5855",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.