NPIMap

Organization Active NPI

Valley Pediatric Dentists P.C.

  • Pediatric Dentistry
  • Mesa, AZ
National Provider Identifier
1295948883
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Randall Keith Lout, DDS MS
Title
President
Phone
(480) 396-3660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X D3911 AZ Primary

Addresses

Primary practice location

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

Mailing address

6239 E Brown Rd
Suite #102
Mesa, AZ 85205-4933
Phone (480) 396-3660

National Provider Directory

National Provider Directory

NPI Registry JSON

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": []
}

Other providers in Mesa, AZ

Sources for this page

  • 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.