Chino Valley PDC PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHINO VALLEY PDC PLLC

Practice address

432 Butterfield Rd
Chino Valley, AZ 86323-5613

Phone

(928) 636-1565

NPI assigned

May 21, 2024

Organization subpart

No

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

Authorized official

Name

Mark Christensen

Title

Credentialing Specialist

Phone

(801) 305-3460

Specialties & licenses 1

Addresses

Other names 1

• Horizon Dental Doing business as

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1659110583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 S 520 W STE 250",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 BUTTERFIELD RD",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863235613",
            "telephone_number": "928-636-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINO VALLEY PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Horizon Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydney Rae Busker, OTD
• Carebridge Health PLLC
• Carelock, LLC
• Chino Valley Bible Church
• Chino Valley Chiropractic Clinic
• Chino Valley Unified School District
• Philana Cicolello
• CL DDS PLLC
• April Rae Clark
• Kiley Lynn Comley, ATC, LAT

• General Practice Dentistry in Chino Valley, AZ
• Providers in Chino Valley, 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 Sep 18, 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.