NPIMap

Organization Active NPI

New Imageorthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Glendale, AZ
National Provider Identifier
1467917310
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
NEW IMAGEORTHODONTICS LLC
Practice address
17235 N 75TH Ave Ste A100
Glendale, AZ 85308-0884
Phone
(623) 825-9445
Fax
(623) 825-9446
NPI assigned
Feb 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Authorized official

Name
Mr. Raul Gomez
Title
Coo
Phone
(623) 825-9445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

17235 N 75TH Ave Ste A100
Glendale, AZ 85308-0884

Mailing address

17235 N 75TH Ave Ste A100
Glendale, AZ 85308-0884
Phone (623) 825-9445

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1467917310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17235 N 75TH AVE STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080884",
            "telephone_number": "623-825-9445",
            "fax_number": "623-825-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17235 N 75TH AVE STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080884",
            "telephone_number": "623-825-9445",
            "fax_number": "623-825-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW IMAGEORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "623-825-9445",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "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 Feb 5, 2019; 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.