Southern Arizona Periodontics PLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

4087 Issued in AZ

Legal business name

SOUTHERN ARIZONA PERIODONTICS PLC

Practice address

5225 E Knight Dr
Ste #401
Tucson, AZ 85712

Phone

(520) 322-9300

Fax

(520) 322-6889

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jacqueline Greenwall

Title

Office Manager

Phone

(520) 322-9300

Specialties & licenses 2

Addresses

Other names 1

• Cole and Sharp PLC Former legal business name

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417055294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 E KNIGHT DR",
            "address_2": "STE #401",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-322-9300",
            "fax_number": "520-322-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 E KNIGHT DR",
            "address_2": "STE #401",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-322-9300",
            "fax_number": "520-322-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ARIZONA PERIODONTICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREENWALL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "520-322-9300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "4087",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "2591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cole and Sharp PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Southern Arizona Neuropsychology Associates LLC
• Southern Arizona Ophthalmology PC
• Southern Arizona Oral & Maxillofacial Surgery, P.C.
• Southern Arizona Orthopedics, P.C.
• Southern Arizona Pathology Associates, LLC.
• Southern Arizona Plastic Surgery, PLLC
• Southern Arizona Rheumatology
• Southern Arizona Rheumatology Associates LLC
• Southern Arizona Surgical Neurophysiology
• Southern Arizona Testing Service

• Periodontics in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Periodontics in Arizona

• 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.