Arizona Dental Professionals, P.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ARIZONA DENTAL PROFESSIONALS, P.C.

Doing business as

Dental Arts of Surprise

Practice address

14815 W Bell Rd Ste 202
Surprise, AZ 85374-7611

Phone

(623) 547-5400

NPI assigned

Sep 29, 2020

Last updated

Sep 29, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

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

Authorized official

Name

Tabatha Lemke

Title

Credentialing Coordinator

Phone

(217) 540-6078

Specialties & licenses 1

Addresses

Other names 1

• Dental Arts of Surprise Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Part of

Frank Nelson DDS PC

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.

• Arizona Dental Professionals, P.C.

  dba Amber Hills Family Dental

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1649481359
  NPPES parent name

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1154938678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14815 W BELL RD STE 202",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14815 W BELL RD STE 202",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747611",
            "telephone_number": "623-547-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Arts of Surprise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.