NPIMap

Organization Active NPI

Ivy 2 Dental, PLLC

Doing business as Desert Valley Pediatric Dentistry

  • Pediatric Dentistry
  • Buckeye, AZ
National Provider Identifier
1588922272
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7256 Issued in AZ
Legal business name
IVY 2 DENTAL, PLLC
Doing business as
Desert Valley Pediatric Dentistry
Practice address
23478 N. Sundance Pkwy West, Suite 103
Buckeye, AZ 85326-3118
Phone
(623) 444-9999
NPI assigned
May 1, 2012
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Dr. Umar ImtiazNPI 1871595983
Title
Owner
Phone
(978) 328-2886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 7256 AZ Primary

Addresses

Primary practice location

23478 N. Sundance Pkwy West, Suite 103
Buckeye, AZ 85326-3118

Mailing address

23374 W Yuma Rd
Ste. 102
Buckeye, AZ 85326-3118
Phone (978) 328-2886

Other names 1

  • Desert Valley Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ivy 2 Dental PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

23478 N Sundance Pkwy
Ste 102
Buckeye, AZ 85326
Phone (623) 444-9999

23478 N Sundance Pkwy
Ste 103
Buckeye, AZ 85326
Phone (623) 444-9999

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1588922272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23374 W YUMA RD",
            "address_2": "STE. 102",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263118",
            "telephone_number": "978-328-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23478 N. SUNDANCE PKWY WEST, SUITE 103",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263118",
            "telephone_number": "623-444-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY 2 DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "IMTIAZ",
        "authorized_official_first_name": "UMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-328-2886",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "7256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Valley Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desert Valley Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.