NPIMap

Organization Active NPI

Arizona Dental Professionals, P.C.

Doing business as Mountain Pass Dental Care

  • General Practice Dentistry
  • Goodyear, AZ
National Provider Identifier
1326781964
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Doing business as
Mountain Pass Dental Care
Practice address
17710 W Elliot Rd
Goodyear, AZ 85338-9000
Phone
(623) 267-1267
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

17710 W Elliot Rd
Goodyear, AZ 85338-9000

Mailing address

17710 W Elliot Rd
Goodyear, AZ 85338-9000
Phone (623) 267-1267

Other names 1

  • Mountain Pass Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Frank Nelson DDS PC63 organizations share this tax ID, including this one
Part of
Frank Nelson DDS 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

Locations

17710 W Elliot Rd
Goodyear, AZ 85338
Phone (623) 267-1267

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1326781964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17710 W ELLIOT RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389000",
            "telephone_number": "623-267-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17710 W ELLIOT RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389000",
            "telephone_number": "623-267-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Pass Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.