Peoria Dental Smiles LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PEORIA DENTAL SMILES LLC

Practice address

9059 W Lake Pleasant Pkwy Ste A100
Peoria, AZ 85382-8393

Phone

(623) 572-0102

NPI assigned

Nov 28, 2022

Organization subpart

No

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

Authorized official

Name

Tera Niedens

Title

Accountant

Phone

(623) 289-2616

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Alexander Santoro, DDS

  • General Practice Dentistry
  • Peoria, AZ
  • NPI 1508915836
  NPD (past)

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1386354751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34225 N 27TH DR STE 241",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856091",
            "telephone_number": "623-289-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY STE A100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828393",
            "telephone_number": "623-572-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA DENTAL SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "NIEDENS",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "623-289-2616"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Peoria",
            "affiliation": "N",
            "address_1": "9059 W Lake Pleasant Pkwy Ste A100",
            "city": "Peoria",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853828393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rochelle Pena, FNP
• Jazmin Penaloza Mata
• Christina M Pence
• Peoria Care Homes LLC
• Peoria Dental Center Group, LLC
• Peoria Dentistry
• Peoria Healthcare LLC
• Peoria Healthy Smiles LLC
• Peoria Mind and Wellness PLLC
• Peoria Oral & Implant Surgery PLLC

• Dental Clinic/Center in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.