Pepsquad PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PEPSQUAD PLLC

Practice address

5215 E Southern Ave
Mesa, AZ 85206-2777

Phone

(509) 823-4480

Fax

(509) 823-4490

NPI assigned

May 18, 2021

Organization subpart

No

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

Authorized official

Name

Derek ThompsonNPI 1982822904

Title

Owner

Phone

(509) 823-4480

Specialties & licenses 4

Addresses

Locations

Practitioners 1

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

• Derek C Thompson, DMD

  • Dentist
  • Union Gap, WA
  • NPI 1982822904
  NPD Authorized official

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1487228961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062777",
            "telephone_number": "509-823-4480",
            "fax_number": "509-823-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEPSQUAD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-823-4480"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pentz Health Services LLC (Nevy Health)
• Debra M Pentz, DC
• People of Color Network
• Daylan Peoples, B.S., SLPA
• Kai Peppard, DC
• Marisa Lyn Perales
• Joanna F Perea
• Leila Pereira, OTR/L
• Pradilka Perera, MD
• Sabrina Perez Avalo

• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.