NPIMap

Organization Active NPI

Ivory Lane LLC

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1356047369
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IVORY LANE LLC
Practice address
8609 E Clydesdale TRL
Scottsdale, AZ 85258-1456
Phone
(775) 771-2197
NPI assigned
Feb 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Authorized official

Name
Stephanie Pagels, DDSNPI 1326484510
Title
Dentist
Phone
(775) 771-2197

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

8609 E Clydesdale TRL
Scottsdale, AZ 85258-1456

Mailing address

8609 E Clydesdale TRL
Scottsdale, AZ 85258-1456
Phone (775) 771-2197

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1356047369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 E CLYDESDALE TRL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852581456",
            "telephone_number": "775-771-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 E CLYDESDALE TRL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852581456",
            "telephone_number": "775-771-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVORY LANE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "PAGELS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "775-771-2197",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.