NPIMap

Organization Active NPI

Emergent Dental Services, LLC

  • General Practice Dentistry
  • Gilbert, AZ
National Provider Identifier
1649972688
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EMERGENT DENTAL SERVICES, LLC
Practice address
2540 S San Tan Village Pkwy Ste 104
Gilbert, AZ 85295-0301
Phone
(480) 892-5089
NPI assigned
Mar 21, 2023
Last updated
Apr 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Authorized official

Name
Dr. Samual W Bollwinkel, DDS
Title
Owner
Phone
(480) 892-5089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2540 S San Tan Village Pkwy Ste 104
Gilbert, AZ 85295-0301

Mailing address

2540 S San Tan Village Pkwy Ste 104
Gilbert, AZ 85295-0301
Phone (480) 892-5089

Other practice location 1

198 W Oak St
Globe, AZ 85501-2544
Phone (928) 425-0670

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1649972688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 S SAN TAN VILLAGE PKWY STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950301",
            "telephone_number": "480-892-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 S SAN TAN VILLAGE PKWY STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950301",
            "telephone_number": "480-892-5089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "198 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Globe",
            "state": "AZ",
            "postal_code": "855012544",
            "country_code": "US",
            "telephone_number": "928-425-0670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERGENT DENTAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "BOLLWINKEL",
        "authorized_official_first_name": "SAMUAL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-892-5089",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.