Dental and Braces Roosevelt PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL AND BRACES ROOSEVELT PLLC

Practice address

1602 E Roosevelt St Ste 301
Phoenix, AZ 85006-3678

Phone

(602) 888-2884

NPI assigned

Feb 6, 2019

Organization subpart

No

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

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1659836369",
    "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": "1602 E ROOSEVELT ST STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063678",
            "telephone_number": "602-888-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL AND BRACES ROOSEVELT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "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": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL OFFICE",
            "identifier": "11901383",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kimberly A Dent, PNP
• Lakisha A Dent, AA,BS,MA,PSYD
• Dental Depot 91St & Indian School, PLLC
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• Dental Design of Arcadia
• Dental Hearts
• Dental Home Concepts

• Dental Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.