NPIMap

Organization Active NPI

Justin Church DMD PLC

Doing business as Yuma Dental

  • Dental Clinic/Center
  • Yuma, AZ
National Provider Identifier
1588990642
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
7892 Issued in AZ
Legal business name
JUSTIN CHURCH DMD PLC
Doing business as
Yuma Dental
Practice address
550 W 16TH St
Yuma, AZ 85364-4632
Phone
(928) 782-0289
Fax
(928) 782-0289
NPI assigned
Oct 26, 2009
Last updated
Nov 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Authorized official

Name
Dr. Justin Church, DMDNPI 1184857419
Title
Dentist
Phone
(480) 206-0139

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
Dental Clinic/Center 261QD0000X 7892 AZ Primary

Addresses

Primary practice location

550 W 16TH St
Yuma, AZ 85364-4632

Mailing address

550 W 16TH St
Yuma, AZ 85364-4632
Phone (928) 782-0289

Other names 1

  • Yuma Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Justin Church DMD PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1588990642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644632",
            "telephone_number": "928-782-0289",
            "fax_number": "928-782-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644632",
            "telephone_number": "928-782-0289",
            "fax_number": "928-782-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN CHURCH DMD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-206-0139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "7892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yuma Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.