Active NPI
Peoria Dentistry
- General Practice Dentistry
- Peoria, AZ
National Provider Identifier
1124858154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- PEORIA DENTISTRY
- Practice address
- 20470 N Lake Pleasant Rd Ste 105
Peoria, AZ 85382-9708 - Phone
- (623) 825-7003
- Fax
- (623) 825-0076
- NPI assigned
- Aug 5, 2024
- Last updated
- Aug 5, 2024
- Organization subpart
- Yes
- Parent organization
- BRIVADENTAL LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Leticia L Rojas
- Title
- Regional Manager
- Phone
- (480) 363-2145
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
20470 N Lake Pleasant Rd Ste 105
Peoria, AZ 85382-9708
Mailing address
20470 N Lake Pleasant Rd Ste 105
Peoria, AZ 85382-9708
Phone (623) 825-7003
National Provider Directory
National Provider Directory- Part of
- Briva Dental LLC
Locations
20470 N Lake Pleasant Rd
Ste 105
Peoria, AZ 85382
Phone (623) 825-7003
Ownership & related parties
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.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722816000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722816000000",
"number": "1124858154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20470 N LAKE PLEASANT RD STE 105",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853829708",
"telephone_number": "623-825-7003",
"fax_number": "623-825-0076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20470 N LAKE PLEASANT RD STE 105",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853829708",
"telephone_number": "623-825-7003",
"fax_number": "623-825-0076"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEORIA DENTISTRY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BRIVADENTAL LLC",
"enumeration_date": "2024-08-05",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A",
"authorized_official_last_name": "ROJAS",
"authorized_official_first_name": "LETICIA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "REGIONAL MANAGER",
"authorized_official_telephone_number": "480-363-2145",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
- Jazmin Penaloza Mata
- Christina M Pence
- Peoria Care Homes LLC
- Peoria Dental Center Group, LLC (Peoria Dental Center)
- Peoria Dental Smiles LLC
- Peoria Healthcare LLC (Peoria Post Acute and Rehabilitation)
- Peoria Healthy Smiles LLC
- Peoria Mind and Wellness PLLC
- Peoria Oral & Implant Surgery PLLC
- Peoria Pain Physicians
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.