Higley Village Kidtastic, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

HIGLEY VILLAGE KIDTASTIC, LLC

Practice address

3303 E Queen Creek Rd
Suite # 106
Gilbert, AZ 85297-8532

Phone

(480) 648-4037

Fax

(480) 696-5505

NPI assigned

Jan 25, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Jaime Johnson

Title

Controller

Phone

(480) 648-4037

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd David Butler, D.D.S

  • Pediatric Dentistry
  • San Tan Valley, AZ
  • NPI 1528322658
  NPD (past)
• Gavin Cotant Christensen, D.M.D.

  • Pediatric Dentistry
  • Phoenix, AZ
  • NPI 1861663635
  NPD (past)

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1447598495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062737",
            "telephone_number": "480-648-4037",
            "fax_number": "480-696-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 E QUEEN CREEK RD",
            "address_2": "SUITE # 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852978532",
            "telephone_number": "480-648-4037",
            "fax_number": "480-696-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGLEY VILLAGE KIDTASTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "480-648-4037",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Higley Park Integrated Health Group LLC
• Higley Unfied School District
• Higley Unified School District
• Higley Unified School District
• Higley Unified School District # 60
• Shaun R Hilburn, DPT
• Benjamin J Hill, PT, DPT, OCS
• Lynette Hill, ED.D.
• Marvin E Hill III, MD
• Ryleigh Michelle Hill

• Pediatric Dentistry in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.