NPIMap

Organization Active NPI

Arizona Pediatric Dental Care

  • Pediatric Dentistry
  • Gilbert, AZ
National Provider Identifier
1437500915
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5685 Issued in AZ
Legal business name
ARIZONA PEDIATRIC DENTAL CARE
Practice address
3011 S Lindsay Rd
108
Gilbert, AZ 85295-4332
Phone
(480) 917-9339
Fax
(480) 821-2980
NPI assigned
Jun 27, 2016
Last updated
Jun 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Dr. Jared W Welch, D.D.S.NPI 1053488650
Title
Owner
Phone
(480) 917-9339

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5685 AZ Primary
Pediatric Dentistry 1223P0221X 8729 AZ

Addresses

Primary practice location

3011 S Lindsay Rd
108
Gilbert, AZ 85295-4332

Mailing address

3011 S Lindsay Rd
108
Gilbert, AZ 85295-4332
Phone (480) 917-9339

Other identifiers 2

IdentifierTypeStateIssuer
821497MedicaidAZ
914227MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1437500915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 S LINDSAY RD",
            "address_2": "108",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954332",
            "telephone_number": "480-917-9339",
            "fax_number": "480-821-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 S LINDSAY RD",
            "address_2": "108",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954332",
            "telephone_number": "480-917-9339",
            "fax_number": "480-821-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA PEDIATRIC DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-917-9339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "5685",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "8729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "821497",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914227",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

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