Organization Active NPI

Bertz Professional Corporation

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
National Provider Identifier
1477075653
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
12096 Issued in AZ
Legal business name
BERTZ PROFESSIONAL CORPORATION
Practice address
3501 N Scottsdale Rd Ste 110
Scottsdale, AZ 85251-5649
Phone
(480) 945-0663
Fax
(480) 947-3991
NPI assigned
Jul 10, 2017
Last updated
Dec 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

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

Authorized official

Name
Jennifer Lucas
Title
Office Manager
Phone
(480) 945-0663

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 12096 AZ Primary

Addresses

Primary practice location

3501 N Scottsdale Rd Ste 110
Scottsdale, AZ 85251-5649

Mailing address

3501 N Scottsdale Rd Ste 110
Scottsdale, AZ 85251-5649
Phone (480) 945-0663

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514505600000",
    "number": "1477075653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515649",
            "telephone_number": "480-945-0663",
            "fax_number": "480-947-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515649",
            "telephone_number": "480-945-0663",
            "fax_number": "480-947-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTZ PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-12-29",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-945-0663"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "12096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.