San Tam Dental Care & Mobile Clinic PC

Primary specialty

DentistTaxonomy code 122300000X

License

3335 Issued in AZ

Legal business name

SAN TAM DENTAL CARE & MOBILE CLINIC PC

Practice address

22240 S Ellsworth Rd
Suite 102
Queen Creek, AZ 85242

Phone

(480) 987-9220

Fax

(480) 987-0502

NPI assigned

May 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christine Lynn Dimero Claveria, DMD

Title

President Dentist

Phone

(480) 987-9220

Specialties & licenses 1

Addresses

Other names 1

• Christine L O Claveria DMD Former legal business name

Locations

Practitioners 1

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.

• Christine Lynn Dinero-Claveria, DMD

  • General Practice Dentistry
  • Queen Creek, AZ
  • NPI 1073832788
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477767010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22240 S ELLSWORTH RD",
            "address_2": "SUITE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85242",
            "telephone_number": "480-987-9220",
            "fax_number": "480-987-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22240 S ELLSWORTH RD",
            "address_2": "SUITE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85242",
            "telephone_number": "480-987-9220",
            "fax_number": "480-987-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN TAM DENTAL CARE & MOBILE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIMERO CLAVERIA",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "480-987-9220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christine L O Claveria DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Charlyssa Sammons
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• Jenna M Sander, CNM
• Zachery Lane Sanders, DO

• Dentist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.