NPIMap

Organization Active NPI

Arizona Dental Professionals, P.C.

Doing business as Dental Care at Madera Vista

  • General Practice Dentistry
  • Green Valley, AZ
National Provider Identifier
1396148789
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Doing business as
Dental Care at Madera Vista
Practice address
140 W Duval Mine Rd
Green Valley, AZ 85614-5002
Phone
(520) 393-0006
Fax
(520) 547-3039
NPI assigned
Sep 30, 2014
Last updated
Mar 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Kim Wilson
Title
Cred Supervisor
Phone
(217) 540-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

140 W Duval Mine Rd
Green Valley, AZ 85614-5002

Mailing address

140 W Duval Mine Rd
Green Valley, AZ 85614-5002
Phone (520) 393-0006

Other names 1

  • Dental Care at Madera Vista Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Frank Nelson DDS PC63 organizations share this tax ID, including this one
Part of
Frank Nelson DDS PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

140 W Duval Mine Rd
Green Valley, AZ 85614
Phone (217) 931-2720

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1396148789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W DUVAL MINE RD",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145002",
            "telephone_number": "520-393-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W DUVAL MINE RD",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145002",
            "telephone_number": "520-393-0006",
            "fax_number": "520-547-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2014-09-30",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Madera Vista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.