Jennifer Thomas Mirabelli, DMD, MSD
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Phoenix, AZ
NPI 1164591863 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164591863
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 6007 (AZ)
- Practice address
- 4901 N 44TH St
#101
Phoenix, AZ 85018-2782 - Phone
- (602) 595-3531
- Fax
- (602) 595-3431
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 6007 | AZ | Yes |
Addresses
Primary practice location
4901 N 44TH St
#101
Phoenix, AZ 85018-2782
Mailing address
4901 N 44TH St
#101
Phoenix, AZ 85018-2782
Phone (602) 595-3531
Other providers in Phoenix, AZ
- Michael Leo Mintz
- Robert John Mintz
- Rose Marie Mintz
- Brandon M Minzer
- Faryal Faisal Mir
- Robert Mark Mirabelli
- Miracle Consulting
- Miracle on 29TH Street
- Miracle Wellness Center LLC
- Mirage Hospice Care Inc
All providers in Phoenix, AZ · Orthodontics and Dentofacial Orthopedics 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 8, 2007. 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.