Queen Creek Modern Dentistry, LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

QUEEN CREEK MODERN DENTISTRY, LLP

Practice address

25166 S Ellsworth Rd Ste B107
Queen Creek, AZ 85142-0326

Phone

(602) 730-9795

NPI assigned

May 10, 2024

Last updated

May 10, 2024By 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

Apeldin Aghassi

Title

DMD

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1619725900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25166 S ELLSWORTH RD STE B107",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851420326",
            "telephone_number": "602-730-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN CREEK MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "AGHASSI",
        "authorized_official_first_name": "APELDIN",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Queen Creek Naturopathic PLLC
• Queen Creek Primary Care, P.C.
• Queen Creek Smiles, LLP (Queen Creek Smiles)
• Queen Creek Unified School District #95
• Jilliann Quesada

• General Practice Dentistry in Queen Creek, AZ
• Providers in Queen Creek, 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 May 10, 2024; 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.