Valley Pediatric Dentists P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D3911 Issued in AZ

Legal business name

VALLEY PEDIATRIC DENTISTS P.C.

Practice address

6239 E Brown Rd
Suite #102
Mesa, AZ 85205-4933

Phone

(480) 396-3660

Fax

(480) 396-3697

NPI assigned

May 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randall Keith Lout, DDS MSNPI 1285697474

Title

President

Phone

(480) 396-3660

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randall Keith Lout, D.D.S.

  • Pediatric Dentistry
  • Mesa, AZ
  • NPI 1285697474
  Authorized official Same address or phone

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295948883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 E BROWN RD",
            "address_2": "SUITE #102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054933",
            "telephone_number": "480-396-3660",
            "fax_number": "480-396-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 E BROWN RD",
            "address_2": "SUITE #102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054933",
            "telephone_number": "480-396-3660",
            "fax_number": "480-396-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PEDIATRIC DENTISTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOUT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-396-3660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D3911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Mentors LLC
• Valley Ophthalmic Facial Plastic Surgery PC
• Valley Outpatient Surgical Center Inc
• Valley Oximetry Incorporated (Valley Sleep Center)
• Valley Pediatric ABA
• Valley Plastic Surgery PLLC
• Valley Sleep Physicians, Inc
• Valley Sleep Therapy Inc
• Valley Therapy (The Valley Therapy)
• Valley Wide Home Health Care, PLLC

• Pediatric Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatric 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.