Kazuki Management LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KAZUKI MANAGEMENT LLC

Doing business as

Great Smiles Dental Care

Practice address

14800 W Mountain View Blvd
Suite 200
Surprise, AZ 85374-4795

Phone

(623) 933-5749

Fax

(623) 815-1220

NPI assigned

Mar 18, 2007

Last updated

Sep 13, 2016By 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. Kimberly A Mack, RDH

Title

Owner

Phone

(480) 231-7020

Specialties & licenses 1

Addresses

Other names 1

• Great Smiles Dental Care Doing business as

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1619091550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 E ROCKY SLOPE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447094",
            "telephone_number": "480-231-7020",
            "fax_number": "480-704-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 W MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744795",
            "telephone_number": "623-933-5749",
            "fax_number": "623-815-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAZUKI MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-18",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-231-7020",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Smiles Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Surprise, AZ
• Providers in Surprise, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.