Arizona Mobile Dental, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ARIZONA MOBILE DENTAL, PC

Practice address

2550 W Union Hills Dr
Suite 202
Phoenix, AZ 85027-5163

Phone

(888) 833-8441

Fax

(888) 330-4331

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Michael Lacorte, DDS

Title

President

Phone

(888) 833-8441

Specialties & licenses 1

Addresses

Other names 1

• Robert L. Birdwell DDS, PC Former legal business name

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526515200000",
    "number": "1497119945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33533 W 12 MILE RD",
            "address_2": "SUITE 150",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313354",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 W UNION HILLS DR",
            "address_2": "SUITE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850275163",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA MOBILE DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2018-05-17",
        "status": "A",
        "authorized_official_last_name": "LACORTE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-833-8441",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert L. Birdwell DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.