Organization Active NPI

Ventana Canyon Dentistry, PLLC

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1548020936
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
VENTANA CANYON DENTISTRY, PLLC
Practice address
5445 N Kolb Rd Ste 205
Tucson, AZ 85750-0750
Phone
(520) 577-7667
Fax
(520) 577-1737
NPI assigned
Mar 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Dr. Alexandra Trinidad Quiroz Martin, DMDNPI 1881180669
Title
Owner/Dentist
Phone
(520) 577-7667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5445 N Kolb Rd Ste 205
Tucson, AZ 85750-0750

Mailing address

5445 N Kolb Rd Ste 205
Tucson, AZ 85750-0750
Phone (520) 577-7667

Other names 1

  • Ventana Dental Doing business as

National Provider Directory

National Provider Directory

Locations

5445 N Kolb Rd
Ste 205
Tucson, AZ 85750
Phone (520) 577-7667

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1548020936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 N KOLB RD STE 205",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857500750",
            "telephone_number": "520-577-7667",
            "fax_number": "520-577-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 N KOLB RD STE 205",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857500750",
            "telephone_number": "520-577-7667",
            "fax_number": "520-577-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTANA CANYON DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "TRINIDAD QUIROZ",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "520-577-7667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ventana Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.