NPIMap

Organization Active NPI

White Mountain Endodontics PLLC

  • Endodontics
  • Show Low, AZ
National Provider Identifier
1255051223
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
WHITE MOUNTAIN ENDODONTICS PLLC
Practice address
2051 Evergreen LN
Show Low, AZ 85901-7928
Phone
(928) 457-1200
Fax
(928) 457-1199
NPI assigned
Aug 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Authorized official

Name
Dr. Jeremy Hargrove, DMD, MSD
Title
Owner
Phone
(928) 243-8598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

2051 Evergreen LN
Show Low, AZ 85901-7928

Mailing address

2051 Evergreen LN Ste a
Show Low, AZ 85901-7928
Phone (928) 457-1200

National Provider Directory

National Provider Directory

Locations

2051 Evergreen Ln
Ste A
Show Low, AZ 85901
Phone (928) 537-4111

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1255051223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 EVERGREEN LN STE A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017928",
            "telephone_number": "928-457-1200",
            "fax_number": "928-457-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 EVERGREEN LN",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017928",
            "telephone_number": "928-457-1200",
            "fax_number": "928-457-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN ENDODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "HARGROVE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-243-8598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MSD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.