NPIMap

Organization Active NPI

Tooth Castle Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Avondale, AZ
National Provider Identifier
1407280241
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D6064 Issued in AZ
Legal business name
TOOTH CASTLE PEDIATRIC DENTISTRY, PLLC
Practice address
10740 W Lower Buckeye Rd Ste 105
Avondale, AZ 85323-9655
Phone
(602) 841-4400
NPI assigned
Aug 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Authorized official

Name
Dr. Maria Angeles Fuentes, DDS
Title
Owner
Phone
(602) 841-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X D6064 AZ Primary

Addresses

Primary practice location

10740 W Lower Buckeye Rd Ste 105
Avondale, AZ 85323-9655

Mailing address

PO Box 32830
Phoenix, AZ 85064-2830
Phone (602) 841-4400

National Provider Directory

National Provider Directory
Tax ID family
Tooth Castle Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1407280241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32830",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850642830",
            "telephone_number": "602-841-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 W LOWER BUCKEYE RD STE 105",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853239655",
            "telephone_number": "602-841-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH CASTLE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ANGELES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-841-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D6064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.