Aesthetic Dental Arts, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5282 Issued in AZ

Legal business name

AESTHETIC DENTAL ARTS, LLC

Practice address

595 N Dobson Rd
Suite B-40
Chandler, AZ 85224-4226

Phone

(480) 786-9030

Fax

(480) 786-4079

NPI assigned

Nov 9, 2016

Last updated

Nov 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Scott Wallin, DDS

Title

Owner

Phone

(480) 786-9030

Specialties & licenses 1

Addresses

Locations

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.

• Alan Wichman

  • General Practice Dentistry
  • Chandler, AZ
  • NPI 1679455901
  NPD (past)

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1346782208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 N DOBSON RD",
            "address_2": "SUITE B-40",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244226",
            "telephone_number": "480-786-9030",
            "fax_number": "480-786-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 N DOBSON RD",
            "address_2": "SUITE B-40",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244226",
            "telephone_number": "480-786-9030",
            "fax_number": "480-786-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC DENTAL ARTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-786-9030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Chandler, AZ
• Providers in Chandler, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.