NPIMap

Organization Active NPI

Desert Rose Dentistry, LLC

  • Dentist
  • Glendale, AZ
National Provider Identifier
1386887719
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D6249 Issued in AZ
Legal business name
DESERT ROSE DENTISTRY, LLC
Practice address
18001 N 79TH Ave
A-8
Glendale, AZ 85308-8388
Phone
(623) 878-8000
NPI assigned
Apr 15, 2009
Last updated
Apr 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Authorized official

Name
Fawne E Pryor
Title
MGR
Phone
(623) 582-3909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D6249 AZ Primary

Addresses

Primary practice location

18001 N 79TH Ave
A-8
Glendale, AZ 85308-8388

Mailing address

18001 N 79TH Ave
A-8
Glendale, AZ 85308-8388
Phone (623) 878-8000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1386887719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE",
            "address_2": "A-8",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088388",
            "telephone_number": "623-878-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE",
            "address_2": "A-8",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088388",
            "telephone_number": "623-878-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT ROSE DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "FAWNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "623-582-3909"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D6249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.