Organization Active NPI

Galaxy Dentistry for Children

  • Dental Anesthesiology
  • Tucson, AZ
National Provider Identifier
1457955213
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
Legal business name
GALAXY DENTISTRY FOR CHILDREN
Practice address
515 E Grant Rd
Tucson, AZ 85705-5797
Phone
(602) 820-0288
NPI assigned
Nov 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Miss Jessica Martinez
Title
Billing Manager
Phone
(602) 820-0288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0004X Primary

Addresses

Primary practice location

515 E Grant Rd
Tucson, AZ 85705-5797

Mailing address

14100 N 83Rd Ave Ste 280
Peoria, AZ 85381-5660
Phone (602) 820-0288

Other identifiers 1

IdentifierTypeStateIssuer
190421MedicaidAZ

National Provider Directory

National Provider Directory

Locations

515 E Grant Rd
Tucson, AZ 85705
Phone (602) 820-0288

Practitioners & affiliated clinicians

Practitioners 1

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": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1457955213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 N 83RD AVE STE 280",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815660",
            "telephone_number": "602-820-0288",
            "fax_number": "602-930-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857055797",
            "telephone_number": "602-820-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALAXY DENTISTRY FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "602-820-0288",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190421",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.