NPIMap

Organization Active NPI

Ultra Dental Peoria LLC

Doing business as Alpha Dental

  • Dentist
  • Peoria, AZ
National Provider Identifier
1336835222
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ULTRA DENTAL PEORIA LLC
Doing business as
Alpha Dental
Practice address
8345 W Thunderbird Rd Ste B100
Peoria, AZ 85381-3668
Phone
(602) 943-3700
NPI assigned
Apr 13, 2023
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Dr. Bobby Yasso, DMDNPI 1700400363
Title
General Dentist
Phone
(248) 705-8334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary
General Practice Dentistry 1223G0001X NU

Addresses

Primary practice location

8345 W Thunderbird Rd Ste B100
Peoria, AZ 85381-3668

Mailing address

8612 W Melinda LN
Peoria, AZ 85382-2499
Phone (248) 705-8334

Other names 1

  • Alpha Dental Doing business as

National Provider Directory

National Provider Directory

Locations

8345 W Thunderbird Rd
Ste B100
Peoria, AZ 85381
Phone (602) 943-3700

Practitioners & affiliated clinicians

Practitioners 2

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": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1336835222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 W MELINDA LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822499",
            "telephone_number": "248-705-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8345 W THUNDERBIRD RD STE B100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813668",
            "telephone_number": "602-943-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA DENTAL PEORIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "YASSO",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "248-705-8334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.