Organization Active NPI

Clarence J. Plisky D.D.S., L.L.C

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1164591624
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5214 Issued in AZ
Legal business name
CLARENCE J. PLISKY D.D.S., L.L.C
Practice address
4910 N 44TH St Ste a-4
Phoenix, AZ 85018-2730
Phone
(602) 952-9521
Fax
(602) 952-0073
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Clarence J. Plisky III, D.D.S.
Title
Owner
Phone
(602) 952-9521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D5214 AZ Primary

Addresses

Primary practice location

4910 N 44TH St Ste a-4
Phoenix, AZ 85018-2730

Mailing address

4910 N 44TH St Ste a-4
Phoenix, AZ 85018-2730
Phone (602) 952-9521

Other names 1

  • Biltmore Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

4910 N 44th St
Ste A4
Phoenix, AZ 85018
Phone (602) 952-9521

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164591624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 N 44TH ST STE A-4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182730",
            "telephone_number": "602-952-9521",
            "fax_number": "602-952-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 N 44TH ST STE A-4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182730",
            "telephone_number": "602-952-9521",
            "fax_number": "602-952-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARENCE J. PLISKY D.D.S., L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PLISKY",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-952-9521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Biltmore Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.