PV Dental Associates LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PV DENTAL ASSOCIATES LLC

Doing business as

Paradise Valley Dental

Practice address

10555 N Tatum Blvd Ste A104
Paradise Valley, AZ 85253-1096

Phone

(480) 998-7775

Fax

(480) 948-4098

NPI assigned

Oct 11, 2022

Last updated

Oct 11, 2022By 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

Jenny Garcia-Rocha

Title

Lead of Credentialing

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Paradise Valley Dental Doing business as

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1366167439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 N TATUM BLVD STE A104",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531096",
            "telephone_number": "480-998-7775",
            "fax_number": "480-948-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 N TATUM BLVD STE A104",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531096",
            "telephone_number": "480-998-7775",
            "fax_number": "480-948-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PV DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "LEAD OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Brian Powley, DDS
• Rosemary Prasad, RN
• Lauren Preble, RN
• Prosperity Consulting (Body By Design)
• Ashley Ranae Pruitt
• PV Surgical Partners LLC (Paradise Valley Specialty Surg Cntr)
• Quality Care Anesthesia, LLC
• Radiant Health Partners LLC
• Peter Konstantine Raisanen, NMD
• Theresa Jean Ramsey, NMD

• General Practice Dentistry in Paradise Valley, AZ
• Providers in Paradise Valley, 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 Oct 11, 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.