Community Dental Services of Az

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

COMMUNITY DENTAL SERVICES OF AZ

Practice address

201 S 36TH St
Phoenix, AZ 85034

Phone

(602) 434-8699

Fax

(602) 391-2380

NPI assigned

Dec 11, 2006

Last updated

Feb 20, 2019By 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. Elizabeth Loelke

Title

Vice President

Phone

(602) 434-8699

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Cristina Loelke, DMD

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1417423104
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1548320609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 36TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85034",
            "telephone_number": "602-434-8699",
            "fax_number": "602-391-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 36TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85034",
            "telephone_number": "602-434-8699",
            "fax_number": "602-391-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL SERVICES OF AZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "LOELKE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "602-434-8699",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161168",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.