NPIMap

Organization Active NPI

Desert Dentistry, PLLC

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1306160791
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DESERT DENTISTRY, PLLC
Practice address
6226 N 27TH Ave
Phoenix, AZ 85017-6241
Phone
(602) 242-0060
NPI assigned
Mar 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Dr. Thomas M Mattern, DDS
Title
Owner
Phone
(602) 432-0538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6226 N 27TH Ave
Phoenix, AZ 85017-6241

Mailing address

6226 N 27TH Ave
Phoenix, AZ 85017-6241
Phone (602) 242-0060

Other names 1

  • Desert Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Desert Dentistry5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6226 N 27th Ave
Phoenix, AZ 85017
Phone (602) 242-0060

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1306160791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6226 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850176241",
            "telephone_number": "602-242-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850176241",
            "telephone_number": "602-242-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "MATTERN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-432-0538",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.