NPIMap

Organization Active NPI

Johnson Ranch Family Dentistry

  • General Practice Dentistry
  • Queen Creek, AZ
National Provider Identifier
1427230770
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5868 Issued in AZ
Legal business name
JOHNSON RANCH FAMILY DENTISTRY
Practice address
270 E Hunt Hwy
BLDG. 3, Suite 14
Queen Creek, AZ 85243-4962
Phone
(480) 888-2271
Fax
(480) 888-7474
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Dr. Scott Dee Wallin, DDSM , PCNPI 1346381282
Title
Dentist
Phone
(480) 888-2271

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5868 AZ Primary

Addresses

Primary practice location

270 E Hunt Hwy
BLDG. 3, Suite 14
Queen Creek, AZ 85243-4962

Mailing address

270 E Hunt Hwy
BLDG. 3, Suite 14
Queen Creek, AZ 85243-4962
Phone (480) 888-2271

National Provider Directory

National Provider Directory

Locations

270 E Hunt Hwy
Ste 14
San Tan Valley, AZ 85143
Phone (480) 888-2271

Practitioners & affiliated clinicians

Practitioners 4

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": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1427230770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E HUNT HWY",
            "address_2": "BLDG. 3, SUITE 14",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852434962",
            "telephone_number": "480-888-2271",
            "fax_number": "480-888-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E HUNT HWY",
            "address_2": "BLDG. 3, SUITE 14",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852434962",
            "telephone_number": "480-888-2271",
            "fax_number": "480-888-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON RANCH FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-888-2271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDSM , PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.