Stetson Village Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STETSON VILLAGE DENTAL LLC

Practice address

3870 W Happy Valley Rd Ste 154
Glendale, AZ 85310-3296

Phone

(623) 533-4895

NPI assigned

Aug 6, 2021

Organization subpart

No

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

Authorized official

Name

Faith Gaskin

Title

Credentialing Directory

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Stetson Village Family Dental Doing business as

Locations

Practitioners 1

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

• Anthony R Brock, D.M.D

  • General Practice Dentistry
  • Glendale, AZ
  • NPI 1083976732
  NPD (past)

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1104590728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3870 W HAPPY VALLEY RD STE 154",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103296",
            "telephone_number": "623-533-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 W HAPPY VALLEY RD STE 154",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103296",
            "telephone_number": "623-533-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STETSON VILLAGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "GASKIN",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTORY",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stetson Village Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sterns Pediatric Clinic,LTD.
• David N. Sternsher, DDS
• Ronald K Sterrenberg, DO
• Peyton Makenna Sterrett
• Stetson Hills Family Medicine PLC
• Steven C. Chang DDS PC
• Steven Q. Hansen D.D.S.P.C.
• Annette Stevens
• Kaleigh Adele Stevens, MSOT/R
• Richard M. Stevens, D.M.D

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.