NPIMap

Organization Active NPI

Western Dental of Arizona, Inc.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1659418994
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WESTERN DENTAL OF ARIZONA, INC.
Practice address
1820 N. 75TH Ave.
Suite #112
Phoenix, AZ 85035
Phone
(623) 846-2223
Fax
(623) 846-2229
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Cindy E. Avalos
Title
Ppocoordinator
Phone
(714) 480-3000

Specialties & licenses 1

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

Addresses

Primary practice location

1820 N. 75TH Ave.
Suite #112
Phoenix, AZ 85035

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 480-3000

National Provider Directory

National Provider Directory
Tax ID family
Western Dental of Arizona Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

1820 N 75th Ave
Ste 112
Phoenix, AZ 85035
Phone (623) 334-2224

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659418994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-480-3000",
            "fax_number": "714-571-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 N. 75TH AVE.",
            "address_2": "SUITE #112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85035",
            "telephone_number": "623-846-2223",
            "fax_number": "623-846-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL OF ARIZONA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AVALOS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PPOCOORDINATOR",
        "authorized_official_telephone_number": "714-480-3000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.