Soh of Arizona Specialty LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SOH OF ARIZONA SPECIALTY LLC

Doing business as

Glendale Orthodontics

Practice address

6120 W Bell Rd Ste 190
Glendale, AZ 85308-3786

Phone

(602) 485-4700

NPI assigned

Aug 9, 2022

Organization subpart

No

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

Authorized official

Name

Ashly Kristine Sunshine

Title

Credentialing Specialist

Phone

(314) 413-2803

Specialties & licenses 1

Addresses

Other names 1

• Glendale Orthodontics Doing business as

Tax ID family

Glendale Orthodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Soh of Arizona Specialty LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Phoenix, AZ
  • NPI 1043938368
  NPD tax ID

Locations

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1104554179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 ELBRIDGE PAYNE RD STE 240",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178544",
            "telephone_number": "636-362-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 W BELL RD STE 190",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083786",
            "telephone_number": "602-485-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOH OF ARIZONA SPECIALTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-09",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "SUNSHINE",
        "authorized_official_first_name": "ASHLY",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "314-413-2803"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendale Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradley William Snyder, IDMT
• Sara Snyder
• Sober Living Lifestyle
• Teresa Socio
• Matthew Lorenc Soderlund, DO
• Sara Mae Soimora
• Sole Care LLC
• Sole Foot and Ankle Specialists PC
• Sole Foot and Ankle Specialists PC
• Ahad B Soleymanzadeh, D.D.S.

• Orthodontics and Dentofacial Orthopedics Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.