Image Dentistry of Glendale, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D5085 Issued in AZ

Legal business name

IMAGE DENTISTRY OF GLENDALE, PC

Practice address

6120 W Bell Rd
Suite 180
Glendale, AZ 85308-3781

Phone

(602) 298-7200

Fax

(602) 298-7202

NPI assigned

Feb 15, 2010

Organization subpart

No

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

Authorized official

Name

Mr. David Farber

Title

Owner

Phone

(602) 298-7200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266192000000",
    "number": "1518289750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 W BELL RD",
            "address_2": "SUITE 180",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083781",
            "telephone_number": "602-298-7200",
            "fax_number": "602-298-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 W BELL RD",
            "address_2": "SUITE 180",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083781",
            "telephone_number": "602-298-7200",
            "fax_number": "602-298-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE DENTISTRY OF GLENDALE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-15",
        "last_updated": "2010-02-15",
        "status": "A",
        "authorized_official_last_name": "FARBER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-298-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; 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.