NPIMap

Organization Active NPI

Fletcher Heights Dental Care PC

  • General Practice Dentistry
  • Peoria, AZ
National Provider Identifier
1396772950
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4974 Issued in AZ
Legal business name
FLETCHER HEIGHTS DENTAL CARE PC
Practice address
8272 W. Lake Pleasant Pkwy., #204
Peoria, AZ 85382-7432
Phone
(623) 825-7833
Fax
(623) 362-9141
NPI assigned
Jun 27, 2006
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. Michael A Prost, D.D.S.NPI 1033405691
Title
Dentist
Phone
(623) 825-7833

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 4974 AZ Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 12010098A IN

Addresses

Primary practice location

8272 W. Lake Pleasant Pkwy., #204
Peoria, AZ 85382-7432

Mailing address

8272 W. Lake Pleasant Pkwy., #204
Peoria, AZ 85382-7432
Phone (623) 825-7833

National Provider Directory

National Provider Directory

Locations

8272 W Lake Pleasant Pkwy
Ste 204
Peoria, AZ 85382
Phone (623) 825-7833

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": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396772950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8272 W. LAKE PLEASANT PKWY., #204",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827432",
            "telephone_number": "623-825-7833",
            "fax_number": "623-362-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8272 W. LAKE PLEASANT PKWY., #204",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827432",
            "telephone_number": "623-825-7833",
            "fax_number": "623-362-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLETCHER HEIGHTS DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROST",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "623-825-7833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4974",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010098A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, 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.