Organization Active NPI

Orthodontics of Yuma, P.C,

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Yuma, AZ
National Provider Identifier
1154742377
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
8613 Issued in AZ
Legal business name
ORTHODONTICS OF YUMA, P.C,
Practice address
1030 W 24TH St Ste C-1
Yuma, AZ 85364-8319
Phone
(928) 343-9559
NPI assigned
Dec 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Joseph A. Wilson, DMD
Title
Owner
Phone
(505) 325-8858

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 8613 AZ
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 8613 AZ Primary

Addresses

Primary practice location

1030 W 24TH St Ste C-1
Yuma, AZ 85364-8319

Mailing address

4760 N Butler Ave Ste B1
Farmington, NM 87401-0816
Phone (505) 325-8858

National Provider Directory

National Provider Directory

Locations

1030 W 24th St
Ste C-1
Yuma, AZ 85364
Phone (928) 343-9559

4760 N Butler Ave
Ste B1
Farmington, NM 87401
Phone (505) 325-0352

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1154742377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE STE B1",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816",
            "telephone_number": "505-325-8858",
            "fax_number": "505-325-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W 24TH ST STE C-1",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648319",
            "telephone_number": "928-343-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTICS OF YUMA, P.C,",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-325-8858",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8613",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "8613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.