NPIMap

Organization Active NPI

Justin Church DMD PLC

  • Dental Clinic/Center
  • Yuma, AZ
National Provider Identifier
1174824619
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
7892 Issued in AZ
Legal business name
JUSTIN CHURCH DMD PLC
Practice address
2540 S 4TH Ave
Yuma, AZ 85364-7286
Phone
(928) 344-5700
Fax
(928) 344-3645
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Dr. Justin Church, D.M.D.NPI 1184857419
Title
Dentist
Phone
(480) 206-0139

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 7892 AZ Primary

Addresses

Primary practice location

2540 S 4TH Ave
Yuma, AZ 85364-7286

Mailing address

2540 S 4TH Ave
Yuma, AZ 85364-7286
Phone (928) 344-5700

Other names 1

  • Yuma Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Justin Church DMD PLC2 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1174824619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 S 4TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647286",
            "telephone_number": "928-344-5700",
            "fax_number": "928-344-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 S 4TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647286",
            "telephone_number": "928-344-5700",
            "fax_number": "928-344-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN CHURCH DMD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-206-0139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "7892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yuma Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.