NPIMap

Organization Active NPI

DHHS IHS Phoenix Area

  • Dental Clinic/Center
  • San Carlos, AZ
National Provider Identifier
1124398961
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DHHS IHS PHOENIX AREA
Practice address
223 Cibecue Circle Road
San Carlos, AZ 85550-0208
Phone
(928) 475-7285
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Mrs. Nella J. Ben
Title
Ceo
Phone
(928) 475-7347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

223 Cibecue Circle Road
San Carlos, AZ 85550-0208

Mailing address

PO Box 208
San Carlos, AZ 85550-0208
Phone (928) 475-7285

Other names 1

  • San Carlos Indian Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DHHS IHS Phoenix Area5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1124398961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855500208",
            "telephone_number": "928-475-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 CIBECUE CIRCLE ROAD",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855500208",
            "telephone_number": "928-475-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS IHS PHOENIX AREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "BEN",
        "authorized_official_first_name": "NELLA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-475-7347",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Carlos Indian Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Carlos, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.