Mogollon Family Dentistry
Organization Active NPI General Practice Dentistry · Overgaard, AZ
NPI 1164344834 · NPPES record last updated Jul 27, 2026
Key facts
- NPI
- 1164344834
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- MOGOLLON FAMILY DENTISTRY
- Practice address
- 3367 Buckskin Rd # 100
Overgaard, AZ 85933 - Phone
- (928) 535-5886
- Fax
- (928) 535-5887
- NPI assigned
- Jul 27, 2026
- Organization subpart
- No
Authorized official
- Name
- Jeffrey Andersen, DO
- Title
- Dentist/ Owner
- Phone
- (928) 535-5886
Corporate family (same tax ID) 1
Practitioners 2
-
Jeffery Dean Andersen, D.D.S
-
Joseph K. Spear, DDS
National Provider Directory
- Tax ID family
- Mogollon Family Dentistry
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
3367 Buckskin Rd # 100
Overgaard, AZ 85933
Mailing address
PO Box 100
Overgaard, AZ 85933-0100
Phone (928) 535-5886
Other providers in Overgaard, AZ
- Heber-Overgaard Fire District
- Daniel Kuhse
- Kelly Marcum
- Marshall M. Willis D.C., P.C.
- Mitchell F Horan MD PC
- Mogollon Family Dentistry
- Mountain Top Transport Services, LLC
- N & R Bryce Enterprises LLC
- Jennifer Smith Owens
- Kimberly Jo Potter
All providers in Overgaard, AZ · General Practice Dentistry in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.