East Riggs Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EAST RIGGS DENTAL LLC

Practice address

2925 E Riggs Rd Ste 2-3
Chandler, AZ 85249-3600

Phone

(480) 581-6633

NPI assigned

Oct 18, 2021

Organization subpart

No

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

Authorized official

Name

Faith Gaskins

Title

Director of Credentialing

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Canyon State Dental Doing business as

Locations

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1396408241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 E RIGGS RD STE 2-3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493600",
            "telephone_number": "480-581-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 E RIGGS RD STE 2-3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493600",
            "telephone_number": "480-581-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST RIGGS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon State Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Chandler, AZ
• Providers in Chandler, 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 Oct 18, 2021; 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.