Organization Active NPI

The Good Dentist LLC

  • General Practice Dentistry
  • Wickenburg, AZ
National Provider Identifier
1306310867
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THE GOOD DENTIST LLC
Practice address
821 W Wickenburg Way
Wickenburg, AZ 85390-4263
Phone
(928) 684-1000
NPI assigned
Jan 17, 2019
Last updated
Apr 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Authorized official

Name
Miranda Jones
Title
Manager
Phone
(623) 302-0220

Specialties & licenses 1

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

Addresses

Primary practice location

821 W Wickenburg Way
Wickenburg, AZ 85390-4263

Mailing address

821 W Wickenburg Way
Wickenburg, AZ 85390-4263
Phone (623) 302-0220

National Provider Directory

National Provider Directory

Locations

821 W Wickenburg Way
Wickenburg, AZ 85390
Phone (928) 684-1000

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1306310867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 W WICKENBURG WAY",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853904263",
            "telephone_number": "623-302-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W WICKENBURG WAY",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853904263",
            "telephone_number": "928-684-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD DENTIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-17",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-302-0220"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickenburg, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.