Dickerson Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

DICKERSON ORTHODONTICS LLC

Practice address

1200 W Warner Rd Ste 1
Chandler, AZ 85224-2758

Phone

(480) 963-2535

NPI assigned

Sep 26, 2024

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Sr Credentialing Team Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Dickerson Orthodontics Doing business as

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1437976701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WARNER RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242758",
            "telephone_number": "480-963-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W WARNER RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242758",
            "telephone_number": "480-963-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKERSON ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickerson Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thalia Diaz, MA
• David A Dibenedetto, DC
• Alexus Dibrell
• Cassidy Sue Dickenson
• Dickerson Orthodontics and Pediatric Dentistry LLC
• Todd Evan Dickerson, DDS MS PC
• Melody Elizabeth Dickson, PHARM D.
• Joseph D Didomenico, MD
• Amber Diego, RT (MR)(R)
• Diehm Chiropractic Center PC

• Orthodontics and Dentofacial Orthopedics Dentistry in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.