Wild West Orthodontics Inc.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0008582 Issued in AZ

Legal business name

WILD WEST ORTHODONTICS INC.

Practice address

14122 W McDowell Rd Ste 200
Goodyear, AZ 85395-2505

Phone

(623) 536-2040

Fax

(623) 536-8555

NPI assigned

Feb 7, 2013

Last updated

Feb 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George Ayoub, DDS

Title

Owner/Doctor

Phone

(623) 536-2040

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Wild West Orthodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wild West Orthodontics P.C

  dba Wild West Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Goodyear, AZ
  • NPI 1649629361
  NPD tax ID

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1164761383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-536-2040",
            "fax_number": "623-536-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-536-2040",
            "fax_number": "623-536-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD WEST ORTHODONTICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "AYOUB",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "623-536-2040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "0008582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1215184528",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lea Whiting
• Aimee Benton Wickersham, LCSW
• Erich A Widemark, PHD, FNP-BC
• Michele Wiest-Alvarez
• Jonathan J Wiggenhorn, D.O.
• Wild West Orthodontics P.C (Wild West Orthodontics)
• Maria Elizabeth Wildey, LCSW
• Wildflower Therapy Services LLC
• Katrina Mae Wiley, WHNP-BC, RNC-OB
• Lisa Charlina Willhite, LPN

• Orthodontics and Dentofacial Orthopedics Dentistry in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.