Wild West Orthodontics P.C

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

WILD WEST ORTHODONTICS P.C

Doing business as

Wild West Orthodontics

Practice address

14122 W McDowell Rd
200
Goodyear, AZ 85395-2503

Phone

(623) 535-6603

NPI assigned

Jun 3, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Mary H Ruiz

Title

Regional Manager

Phone

(623) 536-2040

Specialties & licenses 1

Addresses

Other names 1

• Wild West Orthodontics Doing business as

Tax ID family

Wild West Orthodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wild West Orthodontics Inc.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Goodyear, AZ
  • NPI 1164761383
  NPD tax ID

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1649629361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD",
            "address_2": "200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952503",
            "telephone_number": "623-535-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD",
            "address_2": "200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952503",
            "telephone_number": "623-535-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD WEST ORTHODONTICS P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "623-536-2040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wild West Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aimee Benton Wickersham, LCSW
• Erich A Widemark, PHD, FNP-BC
• Michele Wiest-Alvarez
• Jonathan J Wiggenhorn, D.O.
• Wild West Orthodontics Inc.
• Maria Elizabeth Wildey, LCSW
• Wildflower Therapy Services LLC
• Katrina Mae Wiley, WHNP-BC, RNC-OB
• Lisa Charlina Willhite, LPN
• Adriah Williams

• Orthodontics and Dentofacial Orthopedics Dentistry in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.