NPIMap

Organization Active NPI

West Valley Endodontics and Oral Surgery PLLC

Doing business as West Valley Endodontics And Oral Surgery

  • Dentist
  • Goodyear, AZ
National Provider Identifier
1619444833
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WEST VALLEY ENDODONTICS AND ORAL SURGERY PLLC
Doing business as
West Valley Endodontics And Oral Surgery
Practice address
14122 W McDowell Rd Ste 201
Goodyear, AZ 85395-2505
Phone
(623) 444-4521
Fax
(623) 444-8304
NPI assigned
Oct 25, 2018
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Mrs. Randee L Jackson
Title
Office Manager
Phone
(623) 444-4521

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary
Endodontics 1223E0200X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X

Addresses

Primary practice location

14122 W McDowell Rd Ste 201
Goodyear, AZ 85395-2505

Mailing address

14122 W McDowell Rd Ste 201
Goodyear, AZ 85395-2505
Phone (623) 444-4521

Other names 1

  • West Valley Endodontics And Oral Surgery Doing business as

National Provider Directory

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": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1619444833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 201",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-444-4521",
            "fax_number": "623-444-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 201",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-444-4521",
            "fax_number": "623-444-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY ENDODONTICS AND ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RANDEE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "623-444-4521",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Valley Endodontics And Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Valley Endodontics And Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.