NPIMap

Organization Active NPI

Nordent LLC

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1386860112
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4832 Issued in AZ
Legal business name
NORDENT LLC
Practice address
1423 S Higley Rd
Ste. 123
Mesa, AZ 85206-3429
Phone
(480) 830-3138
Fax
(480) 830-3158
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Farid Ebrahim, D.D.S.NPI 1073663654
Title
Dentist
Phone
(480) 830-3138

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4832 AZ Primary

Addresses

Primary practice location

1423 S Higley Rd
Ste. 123
Mesa, AZ 85206-3429

Mailing address

1423 S Higley Rd
Ste. 123
Mesa, AZ 85206-3429
Phone (480) 830-3138

Other names 1

  • ULTRASMILE Other name

National Provider Directory

National Provider Directory

Locations

1423 S Higley Rd
Ste 123
Mesa, AZ 85206
Phone (480) 830-3138

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": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386860112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 S HIGLEY RD",
            "address_2": "STE. 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063429",
            "telephone_number": "480-830-3138",
            "fax_number": "480-830-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 S HIGLEY RD",
            "address_2": "STE. 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063429",
            "telephone_number": "480-830-3138",
            "fax_number": "480-830-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORDENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EBRAHIM",
        "authorized_official_first_name": "FARID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-830-3138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ULTRASMILE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.