Organization Active NPI

Big Smiles Arizona PC

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1568606507
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7705 Issued in AZ
Legal business name
BIG SMILES ARIZONA PC
Practice address
1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228
Phone
(800) 409-2563
Fax
(623) 321-6268
NPI assigned
Apr 21, 2009
Last updated
Apr 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Miss Deena Chiriac
Title
Credentialing
Phone
(800) 409-2563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7705 AZ Primary

Addresses

Primary practice location

1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228

Mailing address

1904 W Parkside LN
Suite 201
Phoenix, AZ 85027-1228
Phone (800) 409-2563

Other identifiers 1

IdentifierTypeStateIssuer
1760508535MedicaidCA

National Provider Directory

National Provider Directory

Locations

1904 W Parkside Ln
Ste 201
Phoenix, AZ 85027
Phone (623) 551-0986

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1568606507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "800-409-2563",
            "fax_number": "623-321-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "800-409-2563",
            "fax_number": "623-321-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG SMILES ARIZONA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "CHIRIAC",
        "authorized_official_first_name": "DEENA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "800-409-2563",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "7705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760508535",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

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