Starlight Orthodontics & Pediatric Dentistry Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

STARLIGHT ORTHODONTICS & PEDIATRIC DENTISTRY INC

Practice address

3440 W Cactus Rd Ste 1
Phoenix, AZ 85029-2238

Phone

(623) 688-3364

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Albert Tae

Title

Ceo

Phone

(424) 392-2715

Specialties & licenses 5

Addresses

Other names 1

• Starlight Dental Group Doing business as

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1265129852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 W CACTUS RD STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292238",
            "telephone_number": "623-688-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 W CACTUS RD STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292238",
            "telephone_number": "623-688-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT ORTHODONTICS & PEDIATRIC DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-07-25",
        "certification_date": "2023-04-23",
        "status": "A",
        "authorized_official_last_name": "TAE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-392-2715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Starlight Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lenard Starks
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• Starlight Care Transportation LLC
• Starlight Dental Services Inc
• Alexis Marie Starnes, L.AC
• Staroaks Behavioral Home
• Staroaks Behavioral Home
• Staroaks Behavioral Home
• Lorraine A. Starr

• Orthodontics and Dentofacial Orthopedics Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.