Kethcart Sleep LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KETHCART SLEEP LLC

Doing business as

Central Phoenix Center for TMJ, Pain & Sleep Disorders

Practice address

1277 E Missouri Ave Ste 102
Phoenix, AZ 85014-2916

Phone

(602) 615-8516

Fax

(602) 883-7252

NPI assigned

Nov 2, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Wagner Kethcart, DDSNPI 1508897406

Title

Managaing Member/Dentist

Phone

(602) 615-8516

Specialties & licenses 2

Addresses

Other names 1

• Central Phoenix Center for TMJ, Pain & Sleep Disorders Doing business as

Locations

Practitioners 1

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.

• Stephanie Ann Wagner Kethcart, DDS

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1508897406
  Authorized official Same address or phone

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1235641937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142916",
            "telephone_number": "602-615-8516",
            "fax_number": "602-883-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142916",
            "telephone_number": "602-615-8516",
            "fax_number": "602-883-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETHCART SLEEP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "WAGNER KETHCART",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "MANAGAING MEMBER/DENTIST",
        "authorized_official_telephone_number": "602-615-8516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "D6695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Phoenix Center for TMJ, Pain & Sleep Disorders",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Phoenix Center for TMJ, Pain & Sleep Disorders",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regan Kesting, M.S. SLP
• Sanjay Kestner, MC LPC
• Christina Mae Keszler, D.C.
• Ketamine Infusion Centers, Inc (Ketamine Infusion Centers)
• Ketamine Wellness Centers Phoenix LLC
• Kethcart Smiles PLLC
• Kristoffer J Keul, LAC (LICENSED ASSOCI
• Katherine Keuth, LAMFT
• Angie Buono Kevane, RDH, BSDH
• Kevin J Lythgoe MD PC

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.