NPIMap

Organization Active NPI

Dental and Braces Mesa LLC

  • Health Service Clinic/Center
  • Mesa, AZ
National Provider Identifier
1659835932
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
DENTAL AND BRACES MESA LLC
Practice address
1245 E Southern Ave Ste 12
Mesa, AZ 85204-5138
Phone
(480) 636-9970
NPI assigned
Jan 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Authorized official

Name
Liz Ramos
Title
Manager
Phone
(602) 714-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1245 E Southern Ave Ste 12
Mesa, AZ 85204-5138

Mailing address

1515 N Gilbert Rd Ste 107-131
Gilbert, AZ 85234-2318
Phone (602) 714-8203

Other identifiers 1

IdentifierTypeStateIssuer
246754MedicaidAZ

National Provider Directory

National Provider Directory

Locations

1515 N Gilbert Rd
Ste 107131
Gilbert, AZ 85234

Practitioners & affiliated clinicians

Practitioners 7

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": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1659835932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N GILBERT RD STE 107-131",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342318",
            "telephone_number": "602-714-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 E SOUTHERN AVE STE 12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045138",
            "telephone_number": "480-636-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL AND BRACES MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-714-8203"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246754",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.