NPIMap

Organization Active NPI

Rae Lakes, LLC

  • Dental Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1407560675
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RAE LAKES, LLC
Practice address
3317 S Higley Rd
Gilbert, AZ 85297-5436
Phone
(480) 868-1864
NPI assigned
Jan 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Jonathon Edwards, DMDNPI 1013377829
Title
Owner
Phone
(480) 868-1864

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3317 S Higley Rd
Gilbert, AZ 85297-5436

Mailing address

1327 S Nielson St
Gilbert, AZ 85296-4265
Phone (480) 868-1864

National Provider Directory

National Provider Directory

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": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1407560675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 S NIELSON ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964265",
            "telephone_number": "480-868-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852975436",
            "telephone_number": "480-868-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAE LAKES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-868-1864",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.