NPIMap

Organization Active NPI

Legacy Dental Group

Doing business as Louis T Core DDS

  • Non-Pharmacy Dispensing Site
  • Glendale, AZ
National Provider Identifier
1215953161
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
D4729 Issued in AZ
Legal business name
LEGACY DENTAL GROUP
Doing business as
Louis T Core DDS
Practice address
18205 N 51St Ave Ste 101
Glendale, AZ 85308-1491
Phone
(602) 993-4200
Fax
(602) 993-4222
NPI assigned
Jul 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Louis CoreNPI 1477614915
Title
DDS
Phone
(602) 993-4200

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
Non-Pharmacy Dispensing Site 332900000X D4729 AZ Primary

Addresses

Primary practice location

18205 N 51St Ave Ste 101
Glendale, AZ 85308-1491

Mailing address

Poc Management LLC
3000 W Warner Ave
Santa Ana, CA 92704

Other identifiers 1

IdentifierTypeStateIssuer
0353324OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • LOUIS T CORE DDS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arrowhead Plaza Dental Group 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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215953161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POC MANAGEMENT LLC",
            "address_2": "3000 W WARNER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE STE 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081491",
            "telephone_number": "602-993-4200",
            "fax_number": "602-993-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORE",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "602-993-4200"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "AZ",
            "license": "D4729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0353324",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOUIS T CORE DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.