Thunderbird Dental Studio

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5722 Issued in AZ

Legal business name

THUNDERBIRD DENTAL STUDIO

Practice address

9179 W Thunderbird Rd Ste 107
Peoria, AZ 85381-4875

Phone

(623) 933-6010

NPI assigned

Jan 22, 2018

Organization subpart

No

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

Authorized official

Name

Myrna Mendoza

Title

Manager

Phone

(602) 906-9868

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1619485869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9179 W THUNDERBIRD RD STE 107",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814875",
            "telephone_number": "623-933-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9179 W THUNDERBIRD RD STE 107",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814875",
            "telephone_number": "623-933-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDERBIRD DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-906-9868"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Threadgill, LCSW
• Thrive Health IV Clinic, P.C.
• Thrive Health LLC
• Reece Thulstrup
• Thunderbird Dental Management LLC
• Thunderbird Footcare PLC
• Thunderbird Oasis Counseling Inc
• Kresent Thuringer, R.D.
• Tabitha Michelle Tibbett, PHARM. D.
• Eric Tiffany, RN

• General Practice Dentistry in Peoria, AZ
• Providers in Peoria, 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 Jan 22, 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.