Dental and Braces Dysart LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL AND BRACES DYSART LLC

Practice address

1450 N Dysart Rd Ste A7
Avondale, AZ 85323-1534

Phone

(623) 471-6962

Fax

(602) 714-8203

NPI assigned

Oct 9, 2020

Organization subpart

No

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

Authorized official

Name

Elizabeth Ramos

Title

Credentialing

Phone

(602) 726-3221

Specialties & licenses 1

Addresses

Other names 1

• DENTAL AND BRACES DYSART LLC SOMOSDENTAL Former legal business name

Locations

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1629676903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N GILBERT RD STE 107-131",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342318",
            "telephone_number": "602-907-1501",
            "fax_number": "602-714-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 N DYSART RD STE A7",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231534",
            "telephone_number": "623-471-6962",
            "fax_number": "602-714-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL AND BRACES DYSART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "602-726-3221"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTAL AND BRACES DYSART LLC SOMOSDENTAL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dental Clinic/Center in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.