NPIMap

Organization Active NPI

Tuba City Regional Health Care Corporation

Doing business as Sacred Peaks Health Center Dental

  • General Practice Dentistry
  • Flagstaff, AZ
National Provider Identifier
1194301234
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Doing business as
Sacred Peaks Health Center Dental
Practice address
6300 N Highway 89
Flagstaff, AZ 86004
Phone
(928) 863-7333
Fax
(928) 527-2995
NPI assigned
Mar 19, 2021
Last updated
Mar 19, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
TUBA CITY REGIONAL HEALTHCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Authorized official

Name
Lynette Bonar
Title
Chief Executive Officer
Phone
(928) 283-2501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

6300 N Highway 89
Flagstaff, AZ 86004

Mailing address

PO Box 600
Tuba City, AZ 86045-0600
Phone (928) 283-2501

Other names 1

  • Sacred Peaks Health Center Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tuba City Regional Health39 organizations share this tax ID, including this one
Part of
Tuba City Regional Health

Other organizations with this tax ID 38

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

View all 38

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1194301234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N HIGHWAY 89",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86004",
            "telephone_number": "928-863-7333",
            "fax_number": "928-527-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUBA CITY REGIONAL HEALTH CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TUBA CITY REGIONAL HEALTHCARE CORPORATION",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "BONAR",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-283-2501"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Peaks Health Center Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.