Active NPI
Icon Dental PLLC
- General Practice Dentistry
- Phoenix, AZ
National Provider Identifier
1245740182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D05930
- Legal business name
- ICON DENTAL PLLC
- Practice address
- 7435 W Lower Buckeye Rd
Phoenix, AZ 85043-7636 - Phone
- (623) 432-0700
- Fax
- (866) 892-0774
- NPI assigned
- Oct 5, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Z Badalov, DDS
- Title
- Owner
- Phone
- (623) 432-0700
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D05930 | AZ | Primary |
Addresses
Primary practice location
7435 W Lower Buckeye Rd
Phoenix, AZ 85043-7636
Mailing address
7435 W Lower Buckeye Rd
Phoenix, AZ 85043-7636
Phone (623) 432-0700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235163270 | Other | AZ | TYPE 1 NPI |
National Provider Directory
National Provider DirectoryLocations
7435 W Lower Buckeye Rd
Phoenix, AZ 85043
Phone (623) 432-0700
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Tucson, AZ
- NPI 1235163270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1507161600000",
"number": "1245740182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7435 W LOWER BUCKEYE RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850437636",
"telephone_number": "623-432-0700",
"fax_number": "866-892-0774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7435 W LOWER BUCKEYE RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850437636",
"telephone_number": "623-432-0700",
"fax_number": "866-892-0774"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ICON DENTAL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-05",
"last_updated": "2017-10-05",
"status": "A",
"authorized_official_last_name": "BADALOV",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "Z",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "623-432-0700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D05930",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TYPE 1 NPI",
"identifier": "1235163270",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}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 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.