Desert State Dental Anesthesia, LLC

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

Legal business name

DESERT STATE DENTAL ANESTHESIA, LLC

Practice address

625 W Southern Ave Ste E-145
Mesa, AZ 85210-5030

Phone

(480) 332-5541

Fax

(866) 814-1886

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Reuben Nelson Turner, DDSNPI 1184799538

Title

Manager

Phone

(480) 332-5541

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reuben Nelson Turner, D.D.S.

  • Dental Anesthesiology
  • Mesa, AZ
  • NPI 1184799538
  NPD (past) Authorized official
• Mari Cynthia Fukami, DMD

  • Dental Anesthesiology
  • Mesa, AZ
  • NPI 1811066541
  NPD (past)
• Spencer K. Wilde, DDS

  • Dental Anesthesiology
  • Mesa, AZ
  • NPI 1295893196
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1407994676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W SOUTHERN AVE STE E-145",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105030",
            "telephone_number": "480-332-5541",
            "fax_number": "866-814-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W SOUTHERN AVE STE E-145",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105030",
            "telephone_number": "480-332-5541",
            "fax_number": "866-814-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT STATE DENTAL ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-332-5541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "884644",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desert Sounds Audiology and Hearing (Desert Sounds Audiology)
• Desert Sounds Occupational Therapy
• Desert Spine and Scoliosis Center
• Desert Spine and Sports Physicians PLLC
• Desert Star Healthcare, LLC
• Desert Sun Integrated Medicine (Horizon Spine Care)
• Desert Urology Consultants PC
• Desert Valley Eye Care
• Desert Valley Home Health Inc
• Desert Valley Plastic Surgery PLLC

• Dental Anesthesiology in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dental Anesthesiology in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.