NPIMap

Organization Active NPI

Banner -- University Dental Services LLC

  • Dental Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1184094906
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BANNER -- UNIVERSITY DENTAL SERVICES LLC
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(602) 839-2000
NPI assigned
Oct 6, 2015
Organization subpart
Yes
Parent organization
BANNER UNIVERSITY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Dennis Dahlen
Title
Sr VP Finance
Phone
(602) 747-4000

Specialties & licenses 1

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

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

2901 N Central Ave
Phoenix, AZ 85012-2700

National Provider Directory

National Provider Directory
Part of
Alison T Stopeck MD

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1184094906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER -- UNIVERSITY DENTAL SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER UNIVERSITY MEDICAL GROUP",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 6, 2015; 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.