Organization Active NPI

Croft Orthodontics PLLC

Doing business as Vistancia Orthodontics

  • Customized Equipment (DME)
  • Peoria, AZ
National Provider Identifier
1225352289
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
CROFT ORTHODONTICS PLLC
Doing business as
Vistancia Orthodontics
Practice address
9772 W Yearling Rd Ste A1600
Peoria, AZ 85383-1380
Phone
(623) 566-0800
Fax
(833) 330-2854
NPI assigned
Mar 19, 2010
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Dr. Devin L Croft, DDS, MSNPI 1659520617
Title
Owner/ Provider
Phone
(623) 566-0800

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 7616 AZ

Addresses

Primary practice location

9772 W Yearling Rd Ste A1600
Peoria, AZ 85383-1380

Mailing address

9772 W Yearling Rd Ste A1600
Peoria, AZ 85383-1380
Phone (623) 566-0800

Other identifiers 2

IdentifierTypeStateIssuer
162964MedicaidAZ
518939MedicaidAZ

Other names 1

  • Vistancia Orthodontics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100430000265 AZ Part B Supplier - Clinic/Group Practice 7113054792 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, AZ
O20100930055056 AZ DME Supplier - Oral Surgery - Dentist 7113054792 Practice locations: Peoria, AZ

National Provider Directory

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, 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": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1225352289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9772 W YEARLING RD STE A1600",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831380",
            "telephone_number": "623-566-0800",
            "fax_number": "623-566-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9772 W YEARLING RD STE A1600",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831380",
            "telephone_number": "623-566-0800",
            "fax_number": "833-330-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROFT ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "CROFT",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "623-566-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "7616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162964",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "518939",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vistancia Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.