Anthem Dentist

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ANTHEM DENTIST

Practice address

42201 N 41St Dr Ste 156
Anthem, AZ 85086-3803

Phone

(623) 551-3511

Fax

(623) 551-3513

NPI assigned

Sep 1, 2023

Organization subpart

Yes

Parent organization

BRIVADENTAL LLCAs reported in NPPES

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

Authorized official

Name

Leticia Rojas

Title

Regional Manager

Phone

(480) 363-2145

Specialties & licenses 1

Addresses

Part of

Briva Dental LLC

Locations

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.

• Brivadental LLC

  dba AZ Cosmetic & Family Dentistry

  • Clinic/Center
  • Peoria, AZ
  • NPI 1043645765
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chelsea Lynn Jackson

  • Dentist
  • Anthem, AZ
  • NPI 1235786013
  NPD
• Angela Chun Baskin, D.D.S.

  • General Practice Dentistry
  • Anthem, AZ
  • NPI 1326299900
  NPD (past)

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1407632896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42201 N 41ST DR STE 156",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863803",
            "telephone_number": "623-551-3511",
            "fax_number": "623-551-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42201 N 41ST DR STE 156",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863803",
            "telephone_number": "623-551-3511",
            "fax_number": "623-551-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM DENTIST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIVADENTAL LLC",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "480-363-2145"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie D'Onofrio (None)
• Anthem Center for Oral Facial Surgery PC
• Anthem Counseling, LLC
• Anthem Dental Care
• Anthem Dental, LLC (Classical Dentistry of Arizona)
• Anthem Dentistry LLC
• Anthem Endo PLLC (Anthem Endodontics)
• Anthem Endodontics PLLC
• Anthem Eye Care PC (Better Vision)
• Anthem Eye Group PLLC

• General Practice Dentistry in Anthem, AZ
• Providers in Anthem, 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 Sep 1, 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.