Kingman Dental Professionals, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KINGMAN DENTAL PROFESSIONALS, LLC

Practice address

3775 N Stockton Hill Rd
Kingman, AZ 86409-3219

Phone

(480) 295-9234

NPI assigned

Aug 21, 2020

Last updated

Aug 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Lundgreen

Title

Member/Ceo

Phone

(480) 295-9234

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1144832940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7205 E SOUTHERN AVE STE A-122",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852092790",
            "telephone_number": "480-295-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093219",
            "telephone_number": "480-295-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGMAN DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "LUNDGREEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER/CEO",
        "authorized_official_telephone_number": "480-295-9234"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.highdesertdentalaz.com",
            "affiliation": "N",
            "address_1": "3775 N Stockton Hill Rd",
            "city": "Kingman",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "864093219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kingman Academy of Learning
• Kingman Behavioral Health LLC (Hickory Behavioral Center at Kingman)
• Kingman Cancer Center
• Kingman Chiropractic Clinic PC (Dennis D and Ryan D Gustafson DC)
• Kingman Dental Group
• Kingman Emergency Associates PLLC
• Kingman Family Dental Group LLC
• Kingman Family Dentistry
• Kingman Family Practice, P.C.
• Kingman General Surgery PC

• Dental Clinic/Center in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.