Douglas Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DOUGLAS DENTAL, LLC

Practice address

1915 E 10TH St
Douglas, AZ 85607-2407

Phone

(520) 459-3067

Fax

(520) 459-0113

NPI assigned

Dec 3, 2008

Last updated

Dec 3, 2008By 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

Ms. Angela Maria Bejarano

Title

Accounts Receivable

Phone

(520) 459-3067

Specialties & licenses 1

Addresses

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.

• Michael A Leavitt, D.D.S.

  • General Practice Dentistry
  • Sierra Vista, AZ
  • NPI 1073683934
  NPD (past)

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1508001660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 E 10TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072407",
            "telephone_number": "520-459-3067",
            "fax_number": "520-459-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 E 10TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072407",
            "telephone_number": "520-459-3067",
            "fax_number": "520-459-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "BEJARANO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "520-459-3067",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Ann Dickey, LMT
• Nancy Ann Dickson, BSN, MS, CRNA
• Douglas Arc
• Douglas Community Hospital (Cochise Regional Hospital)
• Douglas Community Hospital, Inc. (Cochise Regional Hospital)
• Douglas Family Care PLLC
• Douglas Pharmacy LLC (Douglas Health Mart Pharmacy)
• Douglas Pharmacy, LLC
• Douglas Primary Eye Care PC
• Douglas Unified School District

• General Practice Dentistry in Douglas, AZ
• Providers in Douglas, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.