NPIMap

Organization Active NPI

Heartland Detnal Care of Arizona. PC

  • General Practice Dentistry
  • Queen Creek, AZ
National Provider Identifier
1306158365
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5769 Issued in AR
Legal business name
HEARTLAND DETNAL CARE OF ARIZONA. PC
Practice address
21321 E Ocotillo Rd Ste 133
Queen Creek, AZ 85142-5995
Phone
(217) 540-5141
NPI assigned
Jul 7, 2010
Organization subpart
Yes
Parent organization
HEARTLAND DENTAL CARE OF ARIONA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Authorized official

Name
Kam Shick
Title
Insurance Coordinator
Phone
(217) 540-5141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D5769 AR Primary

Addresses

Primary practice location

21321 E Ocotillo Rd Ste 133
Queen Creek, AZ 85142-5995

Mailing address

21321 E. Ocotillo Road, Suite 133
Queen Creek, AZ 85242-5995
Phone (217) 540-5141

Other names 1

  • Smiles on Ocotillo Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arizona Dental Professionals PC63 organizations share this tax ID, including this one
Part of
Arizona Dental Professionals PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278460800000",
    "number": "1306158365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E. OCOTILLO ROAD, SUITE 133",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852425995",
            "telephone_number": "217-540-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 133",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995",
            "telephone_number": "217-540-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND DETNAL CARE OF ARIZONA. PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL CARE OF ARIONA, PC",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-07-07",
        "status": "A",
        "authorized_official_last_name": "SHICK",
        "authorized_official_first_name": "KAM",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "217-540-5141"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "D5769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles on Ocotillo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.