NPIMap

Organization Active NPI

State 48 Dental PLLC

  • Dental Clinic/Center
  • Glendale, AZ
National Provider Identifier
1437732054
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STATE 48 DENTAL PLLC
Practice address
5122 N 95TH Ave Ste A100
Glendale, AZ 85305-3044
Phone
(602) 312-1348
NPI assigned
May 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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

Authorized official

Name
Brian Truong, DMDNPI 1619289923
Title
Principal
Phone
(602) 312-1348

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

5122 N 95TH Ave Ste A100
Glendale, AZ 85305-3044

Mailing address

5122 N 95TH Ave Ste A100
Glendale, AZ 85305-3044
Phone (602) 312-1348

National Provider Directory

National Provider Directory

Locations

5122 N 95th Ave
Ste A100
Glendale, AZ 85305
Phone (602) 312-1348

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": "1619913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619913600000",
    "number": "1437732054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 N 95TH AVE STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053044",
            "telephone_number": "602-312-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 N 95TH AVE STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053044",
            "telephone_number": "602-312-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE 48 DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "602-312-1348",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.