NPIMap

Organization Active NPI

Desert Dentistry, PLLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1194843987
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DESERT DENTISTRY, PLLC
Practice address
4609 E Chandler Blvd
Phoenix, AZ 85048-0424
Phone
(480) 706-4600
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Dr. Thomas M Mattern, DDSNPI 1295732337
Title
Owner
Phone
(480) 706-4600

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4609 E Chandler Blvd
Phoenix, AZ 85048-0424

Mailing address

4609 E Chandler Blvd
Phoenix, AZ 85048-0424
Phone (480) 706-4600

Other names 1

  • Desert Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Desert Dentistry5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1194843987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480424",
            "telephone_number": "480-706-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480424",
            "telephone_number": "480-706-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "MATTERN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-706-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 21, 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.