NPIMap

Organization Active NPI

Cooley Station Kids Dentist and Orthodontics, LLP

  • General Practice Dentistry
  • Gilbert, AZ
National Provider Identifier
1508959263
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COOLEY STATION KIDS DENTIST AND ORTHODONTICS, LLP
Practice address
4049 E Williams Field Rd Ste 109
Gilbert, AZ 85295-3217
Phone
(480) 840-3600
Fax
(480) 840-3200
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Authorized official

Name
Dr. Cody Cutler, DDS
Title
Owner
Phone
(480) 840-3600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4049 E Williams Field Rd Ste 109
Gilbert, AZ 85295-3217

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 2

  • Cooley Station Dental Group Doing business as
  • TOWNE CENTER DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

4049 E Williams Field Rd
Ste 109
Gilbert, AZ 85295
Phone (480) 840-3600

4996 S Power Rd
Mesa, AZ 85212
Phone (480) 840-3600

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1508959263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 E WILLIAMS FIELD RD STE 109",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953217",
            "telephone_number": "480-840-3600",
            "fax_number": "480-840-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOLEY STATION KIDS DENTIST AND ORTHODONTICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-840-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooley Station Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TOWNE CENTER DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TOWNE CENTER DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.