NPIMap

Organization Active NPI

Az Specialty Dental Services, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Phoenix, AZ
National Provider Identifier
1659137016
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
AZ SPECIALTY DENTAL SERVICES, LLC
Practice address
2330 N 75TH Ave Ste 100
Phoenix, AZ 85035-1200
Phone
(623) 849-0880
NPI assigned
Feb 23, 2024
Organization subpart
Yes
Parent organization
AZ SPECIALTY DENTAL SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Charlotte Dasch
Title
Direc of Cred and Prov Rel
Phone
(504) 638-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2330 N 75TH Ave Ste 100
Phoenix, AZ 85035-1200

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (615) 678-0759

Other names 1

  • Rusty Jones Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Az Specialty Dental Services LLC12 organizations share this tax ID, including this one
Part of
Az Specialty Dental Services LLC

Other organizations with this tax ID 11

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

Locations

2330 N 75th Ave
Ste 100
Phoenix, AZ 85035
Phone (623) 849-0880

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1659137016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 N 75TH AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850351200",
            "telephone_number": "623-849-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ SPECIALTY DENTAL SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AZ SPECIALTY DENTAL SERVICES, LLC",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "DIREC OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rusty Jones Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

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