Ventana Family Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

License

D4654 Issued in AZ

Legal business name

VENTANA FAMILY DENTISTRY LLC

Practice address

20403 N Lake Pleasant Rd
Suite 121
Peoria, AZ 85382-9702

Phone

(623) 566-1200

Fax

(623) 566-0114

NPI assigned

Dec 22, 2015

Organization subpart

No

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

Authorized official

Name

Craig Thompson

Title

Owner/Dentist

Phone

(623) 566-1200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1295190072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20403 N LAKE PLEASANT RD",
            "address_2": "SUITE 121",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829702",
            "telephone_number": "623-566-1200",
            "fax_number": "623-566-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20403 N LAKE PLEASANT RD",
            "address_2": "SUITE 121",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829702",
            "telephone_number": "623-566-1200",
            "fax_number": "623-566-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTANA FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "623-566-1200"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D4654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.