Organization Active NPI

Dynamic Dental Mobile LLC

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1356892780
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DYNAMIC DENTAL MOBILE LLC
Practice address
7170 E McDonald Dr
Scottsdale, AZ 85253-5408
Phone
(480) 646-6004
NPI assigned
Oct 20, 2016
Last updated
Oct 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
Mr. Marc A Resasco
Title
Owner
Phone
(480) 646-6004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

7170 E McDonald Dr
Scottsdale, AZ 85253-5408

Mailing address

60 Lorraine CT
Holbrook, NY 11741-1540

National Provider Directory

National Provider Directory

Locations

7170 E McDonald Dr
Scottsdale, AZ 85253
Phone (480) 646-6004

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1356892780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 LORRAINE CT",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7170 E MCDONALD DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852535408",
            "telephone_number": "480-646-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DENTAL MOBILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "RESASCO",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-646-6004",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "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 Oct 20, 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.