Dickerson Orthodontics and Pediatric Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DICKERSON ORTHODONTICS AND PEDIATRIC DENTISTRY LLC

Practice address

1200 W Warner Rd Ste 1
Chandler, AZ 85224-2758

Phone

(480) 963-2535

NPI assigned

Sep 22, 2022

Last updated

Sep 22, 2022By 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

Dr. Todd Dickerson, DDSNPI 1548393317

Title

Owner

Phone

(602) 799-4093

Specialties & licenses 1

Addresses

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.

• Todd Evan Dickerson, DDS MS PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chandler, AZ
  • NPI 1548393317
  Authorized official Same address or phone

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1154044386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WARNER RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242758",
            "telephone_number": "480-963-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W WARNER RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242758",
            "telephone_number": "480-963-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKERSON ORTHODONTICS AND PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-799-4093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorena J Diaz, LMSW
• Thalia Diaz, MA
• David A Dibenedetto, DC
• Alexus Dibrell
• Cassidy Sue Dickenson
• Dickerson Orthodontics LLC (Dickerson Orthodontics)
• Todd Evan Dickerson, DDS MS PC
• Melody Elizabeth Dickson, PHARM D.
• Joseph D Didomenico, MD
• Amber Diego, RT (MR)(R)

• Dental Clinic/Center in Chandler, AZ
• Providers in Chandler, 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 Sep 22, 2022; 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.