Community Dental Partners

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5063 Issued in AZ

Legal business name

COMMUNITY DENTAL PARTNERS

Practice address

21321 E Ocotillo Rd
BLDG C Ste.106
Queen Creek, AZ 85142-5996

Phone

(602) 370-1511

Fax

(602) 265-4007

NPI assigned

Feb 14, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Eoin Kirby

Title

Credentialing Supervisor

Phone

(602) 370-1511

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1386917839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 N 24TH ST",
            "address_2": "STE. 23",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167358",
            "telephone_number": "602-370-1511",
            "fax_number": "602-265-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD",
            "address_2": "BLDG C STE.106",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425996",
            "telephone_number": "602-370-1511",
            "fax_number": "602-265-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "EOIN",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "602-370-1511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5063",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D5110",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D1819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Matthew Alexander Cook, FNP
• Holly Maria Cooney, PA

• General Practice Dentistry in Queen Creek, AZ
• Providers in Queen Creek, 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 Feb 29, 2012; 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.