Bellroad Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BELLROAD DENTISTRY LLC

Practice address

17061 N Avenue of the Arts Ste 101
Surprise, AZ 85378-6996

Phone

(623) 246-5025

NPI assigned

Nov 19, 2020

Organization subpart

No

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

Authorized official

Name

Tera Goolsby

Title

Accountant

Phone

(623) 289-2616

Specialties & licenses 1

Addresses

Other names 1

• Bell Road Dentistry Doing business as

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kip Nielsen, D.M.D.

  • Dentist
  • Suprise, AZ
  • NPI 1649646795
  NPD
• Jeffrey Scott Evers, DMD

  • Dentist
  • Gilbert, AZ
  • NPI 1386076081
  NPD (past)

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1245833441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34225 N 27TH DR STE 241",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856091",
            "telephone_number": "623-289-2616",
            "fax_number": "623-289-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17061 N AVENUE OF THE ARTS STE 101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853786996",
            "telephone_number": "623-246-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLROAD DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "623-289-2616"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Surprise",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "17061 N Avenue Of The Arts Ste 101",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853786996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bell Road Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Bell
• Nash Bell, DPT
• Belles Pharmacy LLC
• Belles Pharmacy LLC
• Nicholas P Bellinaso, DPT
• Travis H Belnap, HAD
• Bruce Joseph Benaglio, PA-C
• Whitney Benard
• Zsuzsanna Benegui, LPN
• Lana Bengez-Pudja, PHARMD

• Dental Clinic/Center in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.