NPIMap

Organization Active NPI

Souza DDS LLC

  • Dental Clinic/Center
  • Glendale, AZ
National Provider Identifier
1487425617
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SOUZA DDS LLC
Practice address
17215 N 72ND Dr Ste A100
Glendale, AZ 85308-8557
Phone
(602) 363-8715
NPI assigned
Jan 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Dr. Sergio Souza, DDSNPI 1952778532
Title
DDS
Phone
(623) 582-8384

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

17215 N 72ND Dr Ste A100
Glendale, AZ 85308-8557

Mailing address

17215 N 72ND Dr Ste A100
Glendale, AZ 85308-8557
Phone (602) 363-8715

Other names 1

  • North Canyon Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

17215 N 72nd Dr
Ste A100
Glendale, AZ 85308
Phone (602) 363-8715

Practitioners & affiliated clinicians

Practitioners 3

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": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1487425617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 N 72ND DR STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088557",
            "telephone_number": "602-363-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17215 N 72ND DR STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088557",
            "telephone_number": "602-363-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUZA DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "SOUZA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "623-582-8384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Canyon Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 16, 2024; 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.