NPIMap

Organization Active NPI

Dynamic Dental Health Associates of Arizona

  • General Practice Dentistry
  • Laveen, AZ
National Provider Identifier
1376974352
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONA
Practice address
5030 W Baseline Rd Ste 131
Laveen, AZ 85339-7331
Phone
(602) 237-8880
Fax
(602) 237-8419
NPI assigned
Dec 2, 2013
Organization subpart
Yes
Parent organization
DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Rosa Lesso
Title
National Director of RCM
Phone
(714) 571-3471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5030 W Baseline Rd Ste 131
Laveen, AZ 85339-7331

Mailing address

136 4TH St N Ste 201
St Petersburg, FL 33701-3889
Phone (727) 800-8026

Other names 1

  • Prime Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Dental Health Associates of Arizona5 organizations share this tax ID, including this one
Part of
Dynamic Dental Health Associates of Arizona

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5030 W Baseline Rd
Ste 131
Laveen, AZ 85339
Phone (602) 237-8880

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1376974352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 4TH ST N STE 201",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013889",
            "telephone_number": "727-800-8026",
            "fax_number": "727-304-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 W BASELINE RD STE 131",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397331",
            "telephone_number": "602-237-8880",
            "fax_number": "602-237-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONA",
        "enumeration_date": "2013-12-02",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "LESSO",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR OF RCM",
        "authorized_official_telephone_number": "714-571-3471"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prime Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.