NPIMap

Organization Active NPI

Family Dental at Moon Valley

Doing business as Dental Care of Moon Valley

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1225409014
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9188 Issued in AZ
Legal business name
FAMILY DENTAL AT MOON VALLEY
Doing business as
Dental Care of Moon Valley
Practice address
15640 N 7TH St Ste A4
Phoenix, AZ 85022-3520
Phone
(602) 843-6000
NPI assigned
Oct 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Chad Hines, DDSNPI 1497067102
Title
Dentist, Owner
Phone
(319) 331-3709

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: 193400000X SINGLE SPECIALTY GROUP 122300000X 9188 AZ Primary

Addresses

Primary practice location

15640 N 7TH St Ste A4
Phoenix, AZ 85022-3520

Mailing address

15640 N 7TH St Ste A4
Phoenix, AZ 85022-3520
Phone (602) 843-6000

Other names 1

  • Dental Care of Moon Valley Doing business as

National Provider Directory

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": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1225409014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15640 N 7TH ST STE A4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223520",
            "telephone_number": "602-843-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15640 N 7TH ST STE A4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223520",
            "telephone_number": "602-843-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL AT MOON VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "DENTIST, OWNER",
        "authorized_official_telephone_number": "319-331-3709",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Moon Valley",
            "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 Oct 19, 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.