NPIMap

Organization Active NPI

Az Perio PLLC

Doing business as Paradise Valley Periodontics

  • Periodontics
  • Scottsdale, AZ
National Provider Identifier
1437222809
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
5633 Issued in AZ
Legal business name
AZ PERIO PLLC
Doing business as
Paradise Valley Periodontics
Practice address
7425 E Shea Blvd Ste 110
Scottsdale, AZ 85260-6411
Phone
(480) 991-0090
Fax
(480) 951-2278
NPI assigned
Nov 15, 2006
Last updated
Jan 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Dr. Steven Gordon Reitan, DDSNPI 1518034057
Title
President
Phone
(480) 991-0090

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 2104 AZ
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 5633 AZ Primary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 5031 AZ
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 6988 AZ

Addresses

Primary practice location

7425 E Shea Blvd Ste 110
Scottsdale, AZ 85260-6411

Mailing address

7425 E Shea Blvd Ste 110
Scottsdale, AZ 85260-6411
Phone (480) 991-0090

Other names 1

  • Paradise Valley Periodontics Doing business as

National Provider Directory

National Provider Directory

Locations

10555 N Tatum Blvd
Ste A106
Paradise Vly, AZ 85253
Phone (480) 563-4145

7425 E Shea Blvd
Ste 110
Scottsdale, AZ 85260
Phone (480) 991-0090

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1437222809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 E SHEA BLVD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606411",
            "telephone_number": "480-991-0090",
            "fax_number": "480-951-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 E SHEA BLVD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606411",
            "telephone_number": "480-991-0090",
            "fax_number": "480-951-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ PERIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "REITAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-991-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "2104",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "5633",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "5031",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "6988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Valley Periodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paradise Valley Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.