Organization Active NPI

Dental Care of Mesa LLC

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1174098255
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL CARE OF MESA LLC
Practice address
6610 E Baseline Rd
Ste 104
Mesa, AZ 85206-4441
Phone
(480) 290-7777
Fax
(480) 290-7776
NPI assigned
Oct 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Authorized official

Name
Julee Weidner, DDS
Title
Doctor
Phone
(480) 290-7777

Specialties & licenses 1

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

Addresses

Primary practice location

6610 E Baseline Rd
Ste 104
Mesa, AZ 85206-4441

Mailing address

6610 E Baseline Rd Ste 104
Mesa, AZ 85206-4441
Phone (480) 290-7777

National Provider Directory

National Provider Directory

Locations

6610 E Baseline Rd
Ste 104
Mesa, AZ 85206
Phone (480) 290-7777

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1174098255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6610 E BASELINE RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064441",
            "telephone_number": "480-290-7777",
            "fax_number": "480-290-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6610 E BASELINE RD",
            "address_2": "STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064441",
            "telephone_number": "480-290-7777",
            "fax_number": "480-290-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE OF MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "WEIDNER",
        "authorized_official_first_name": "JULEE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-290-7777",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.