21152 Rittenhouse LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

21152 RITTENHOUSE LLC

Doing business as

Brush Dental

Practice address

22717 S Ellsworth Rd Ste B102
Queen Creek, AZ 85142-7575

Phone

(480) 888-9596

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By 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

Matthew Baker, DDS

Title

Member

Phone

(480) 215-5133

Specialties & licenses 1

Addresses

Other names 1

• Brush Dental Doing business as

Locations

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1609343680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22717 S ELLSWORTH RD STE B102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427575",
            "telephone_number": "480-888-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22717 S ELLSWORTH RD STE B102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427575",
            "telephone_number": "480-888-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21152 RITTENHOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-215-5133",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brush Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.