Signature Arizona Dental Partners LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SIGNATURE ARIZONA DENTAL PARTNERS LLC

Practice address

2525 S Rural Rd Ste 2S
Tempe, AZ 85282-2400

Phone

(480) 967-5788

NPI assigned

Nov 20, 2018

Organization subpart

Yes

Parent organization

SIGNATURE DENTAL PARTNERS LLCAs reported in NPPES

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

Authorized official

Name

Melody Bennion

Title

Director of Integrations

Phone

(480) 234-8490

Specialties & licenses 1

Addresses

Other names 1

• Family Dentistry of Buckeye Doing business as

Part of

Signature Dental Partners LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Signature Dental Partners LLC

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1699308866
  NPPES parent name

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge Luis Alvarez, DDS

  • General Practice Dentistry
  • Tucson, AZ
  • NPI 1710095401
  NPD (past)
• Eva Bernaciak, DMD

  • Dentist
  • Tempe, AZ
  • NPI 1750937991
  NPD (past)
• Michael D Broadbent, DDS PC

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1326162066
  NPD (past)
• Michael Tyler Broadbent, D.D.S.

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1710390448
  NPD (past)
• Kyle Cordner, D.D.S.

  • General Practice Dentistry
  • Tempe, AZ
  • NPI 1124478938
  NPD (past)
• Mark Curtis, DDS

  • Dentist
  • Mesa, AZ
  • NPI 1154534469
  NPD (past)
• John William Dovgan, DDS

  • Dentist
  • Phoenix, AZ
  • NPI 1124011358
  NPD (past)
• Stevan Karl Forney, DDS

  • General Practice Dentistry
  • Tempe, AZ
  • NPI 1326137670
  NPD (past)
• Chet L. Jenkins, D.D.S.

  • Dentist
  • Mesa, AZ
  • NPI 1750502456
  NPD (past)
• Albert Lin

  • Dentist
  • Chandler, AZ
  • NPI 1255840377
  NPD (past)
• Jana L Long, DMD

  • General Practice Dentistry
  • Cottonwood, AZ
  • NPI 1083784722
  NPD (past)
• Jeremy Michael Miller, D.D.S.

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1235494428
  NPD (past)

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1104395094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N 44TH ST STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850087622",
            "telephone_number": "480-626-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S RURAL RD STE 2S",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822400",
            "telephone_number": "480-967-5788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 S Watson Rd Ste A-100",
            "address_purpose": "LOCATION",
            "city": "Buckeye",
            "state": "AZ",
            "postal_code": "853266303",
            "country_code": "US",
            "telephone_number": "623-471-7373",
            "fax_number": "623-888-8270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3841 E Thunderbird Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850325719",
            "country_code": "US",
            "telephone_number": "602-867-1899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13920 W. Camino del Sol",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853752400",
            "country_code": "US",
            "telephone_number": "623-974-4753",
            "fax_number": "623-974-4753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6562 E Carondelet Dr",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857102117",
            "country_code": "US",
            "telephone_number": "520-722-1655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2074 E Southern Ave Ste B102",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852827534",
            "country_code": "US",
            "telephone_number": "480-838-3355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9301 E Shea Blvd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852606735",
            "country_code": "US",
            "telephone_number": "480-767-8804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 E Palm Ln Ste A280",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850044603",
            "country_code": "US",
            "telephone_number": "602-252-2800",
            "fax_number": "602-254-8228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2512 E Vistoso Commerce Loop",
            "address_purpose": "LOCATION",
            "city": "Oro Valley",
            "state": "AZ",
            "postal_code": "857559117",
            "country_code": "US",
            "telephone_number": "520-797-4844",
            "fax_number": "520-219-0863",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1058 N Higley Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852056463",
            "country_code": "US",
            "telephone_number": "480-924-8633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "335 N Stapley Dr",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852038030",
            "country_code": "US",
            "telephone_number": "480-964-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18275 N 59th Ave Ste D-120",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853081260",
            "country_code": "US",
            "telephone_number": "602-943-7204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3592 S Atherton Blvd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977444",
            "country_code": "US",
            "telephone_number": "480-457-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "637 N Main St Ste 1C",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863265579",
            "country_code": "US",
            "telephone_number": "928-634-8292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIGNATURE ARIZONA DENTAL PARTNERS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIGNATURE DENTAL PARTNERS LLC",
        "enumeration_date": "2018-11-20",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "BENNION",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATIONS",
        "authorized_official_telephone_number": "480-234-8490"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry of Buckeye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Shumway, LAC
• Lacey Shupe, OTRL
• Maureen A. Siegel, COTA
• Sigma Recovery Center LLC
• Sigma Wellness Center LLC
• Andre M Silano, DC
• Adolph Silberman, ED.D.
• Marcia Silberman, M.A.
• Brian Nathan Sillanpaa
• William Silverman, MD

• All providers in Tempe, AZ
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.