NPIMap

Organization Active NPI

Mountain Park Dentistry L.L.C.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1457719114
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MOUNTAIN PARK DENTISTRY L.L.C.
Practice address
15215 S 48TH St Ste 175
Phoenix, AZ 85044-9140
Phone
(480) 759-9300
Fax
(480) 759-2130
NPI assigned
Feb 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Dr. Randy Mow, D.D.S.NPI 1043388010
Title
Owner
Phone
(480) 759-9300

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X

Addresses

Primary practice location

15215 S 48TH St Ste 175
Phoenix, AZ 85044-9140

Mailing address

15215 S 48TH St Ste 175
Phoenix, AZ 85044-9140
Phone (480) 759-9300

National Provider Directory

National Provider Directory

Locations

15215 S 48th St
Ste 175
Phoenix, AZ 85044
Phone (480) 759-9300

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1457719114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST STE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449140",
            "telephone_number": "480-759-9300",
            "fax_number": "480-759-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 S 48TH ST STE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850449140",
            "telephone_number": "480-759-9300",
            "fax_number": "480-759-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN PARK DENTISTRY L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "MOW",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-759-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.