Southern Dental

Primary specialty

DentistTaxonomy code 122300000X

License

5995 Issued in AZ

Legal business name

SOUTHERN DENTAL

Practice address

3320 W. Southern Avenue
Suite # 108
Phoenix, AZ 85041

Phone

(602) 305-8800

Fax

(602) 305-8801

NPI assigned

Dec 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter P Nguyen, DMD

Title

Dentist

Phone

(602) 305-8800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1265616213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 W. SOUTHERN AVENUE",
            "address_2": "SUITE # 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85041",
            "telephone_number": "602-305-8800",
            "fax_number": "602-305-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 W. SOUTHERN AVENUE",
            "address_2": "SUITE # 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85041",
            "telephone_number": "602-305-8800",
            "fax_number": "602-305-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "602-305-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southern Arizona Psychological Services PLLC
• Southern Assisted Living, LLC
• Southern Comfort Hospice Care Inc
• Southern Dental LLC
• Southern Smiles Dental PLLC
• Terrance Southern, LPC
• Southland Geriatric & Palliative Care, LLC
• Southland Home Care, LLC

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.