Aesthetic Family Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4906 Issued in AZ

Legal business name

AESTHETIC FAMILY DENTISTRY PC

Practice address

26232 N Tatum Blvd Ste 400
Phoenix, AZ 85050-7504

Phone

(480) 515-0404

Fax

(480) 515-2587

NPI assigned

Jan 28, 2009

Last updated

Jan 28, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

AESTHETIC FAMILY DENTISTRY PCAs reported in NPPES

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

Authorized official

Name

Dr. Russell W. Roderick, DMDNPI 1912013020

Title

Doctor

Phone

(480) 515-0404

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.

• Russell W Roderick, D.M.D

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1912013020
  NPD (past) Authorized official

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1518105691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26232 N TATUM BLVD STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507504",
            "telephone_number": "480-515-0404",
            "fax_number": "480-515-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26232 N TATUM BLVD STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507504",
            "telephone_number": "480-515-0404",
            "fax_number": "480-515-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC FAMILY DENTISTRY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AESTHETIC FAMILY DENTISTRY PC",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-515-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aegis Iom, PLLC
• Aeromedics LLC
• Alexa Aeschleman
• Brittany Aeschlimann, M.D.
• Aesthetic Anesthesiology Consultants PLLC
• Aesthetic Surgeons of Arizona, P.C.
• Aesthetic Surgery Institute,P.C.
• Aesthetica PLLC
• Aetna Better Health of Nevada Inc. (Aetna Better Health of Nevada)
• Aetna Better Health of Nevada Inc. (Aetna Better Health of Nevada)

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, 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 Jan 28, 2009; 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.