Organization Active NPI

Josho Management

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1114305158
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D4234 Issued in AZ
Legal business name
JOSHO MANAGEMENT
Practice address
4505 E Chandler Blvd
Suite 150
Phoenix, AZ 85048-7684
Phone
(480) 753-3692
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Authorized official

Name
Kim Mack
Title
Owner/ Managing Director
Phone
(480) 231-7020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D4234 AZ Primary

Addresses

Primary practice location

4505 E Chandler Blvd
Suite 150
Phoenix, AZ 85048-7684

Mailing address

4505 E Chandler Blvd
Suite 150
Phoenix, AZ 85048-7684
Phone (480) 753-3692

Other names 1

  • Foothills Vista Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

4505 E Chandler Blvd
Ste 150
Phoenix, AZ 85048
Phone (480) 753-3692

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1114305158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 E CHANDLER BLVD",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487684",
            "telephone_number": "480-753-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 E CHANDLER BLVD",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487684",
            "telephone_number": "480-753-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHO MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER/ MANAGING DIRECTOR",
        "authorized_official_telephone_number": "480-231-7020"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D4234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothills Vista Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.