Organization Active NPI

Rejuvedent Grove, LLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1184568974
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
REJUVEDENT GROVE, LLC
Practice address
4280 E Camelback Rd Ste 100
Phoenix, AZ 85018-2751
Phone
(480) 919-7358
NPI assigned
Apr 14, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Ms. Tina Tran
Title
Ceo
Phone
(415) 609-7158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4280 E Camelback Rd Ste 100
Phoenix, AZ 85018-2751

Mailing address

5000 N Camelback Ridge Dr Unit 202
Scottsdale, AZ 85251-3433
Phone (415) 609-7158

National Provider Directory

National Provider Directory

Locations

4280 E Camelback Rd
Ste 100
Phoenix, AZ 85018
Phone (480) 919-7358

NPI Registry JSON

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1184568974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 N CAMELBACK RIDGE DR UNIT 202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513433",
            "telephone_number": "415-609-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 E CAMELBACK RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182751",
            "telephone_number": "480-919-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVEDENT GROVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-609-7158",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "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 Apr 14, 2026; 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.