BCKK 83Rd and Camelback LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BCKK 83RD AND CAMELBACK LLC

Practice address

8141 W Camelback Rd
Suite 3
Phoenix, AZ 85033-1050

Phone

(623) 848-9100

Fax

(623) 247-3917

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Ki Ngo, DMD

Title

President Owner

Phone

(480) 917-0181

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coyote Ridge Family Dentistry Doing business as

Locations

Practitioners 1

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

• Yonas H.N. Yohannes, DDS

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1679530992
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285853671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 W CAMELBACK RD",
            "address_2": "SUITE 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850331050",
            "telephone_number": "623-848-9100",
            "fax_number": "623-247-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8141 W CAMELBACK RD",
            "address_2": "SUITE 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850331050",
            "telephone_number": "623-848-9100",
            "fax_number": "623-247-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BCKK 83RD AND CAMELBACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "KI",
        "authorized_official_title_or_position": "PRESIDENT  OWNER",
        "authorized_official_telephone_number": "480-917-0181",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI",
            "identifier": "1808900",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coyote Ridge Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.