Pacific Dental Services Foundation

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

PACIFIC DENTAL SERVICES FOUNDATION

Practice address

4559 E. Bell Road, Ste 106
Phoenix, AZ 85032

Phone

(714) 845-8500

Fax

(303) 952-0892

NPI assigned

Oct 31, 2018

Last updated

Mar 28, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jack Dillenberg

Title

Owner

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Joseph Wachter, D.M.D.

  • Dentist
  • Queen Creek, AZ
  • NPI 1669992194
  Medicare reassignment NPD
• Kathleen Ashley Abaie, DMD

  • Dentist
  • Phoenix, AZ
  • NPI 1629451711
  NPD
• Meelin Dian Chin Kit-Wells, DDS

  • Pediatric Dentistry
  • Phoenix, AZ
  • NPI 1265507099
  NPD
• Talitha Marie Jesse

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1669823829
  NPD
• David Jourabchi, DDS

  • Pediatric Dentistry
  • Phoenix, AZ
  • NPI 1972023372
  NPD
• Nicku Renee Keshavarz, DDS

  • Dentist
  • Cave Creek, AZ
  • NPI 1295576098
  NPD
• Jamal Wells, DDS

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1801450242
  NPD
• Luz Molina, D.M.D,M.S.

  • Pediatric Dentistry
  • Scottsdale, AZ
  • NPI 1194864884
  NPD (past)
• Jacob Ryan Dent, D.D.S

  • General Practice Dentistry
  • Missouri City, TX
  • NPI 1366597890
  NPD (past)

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1659848208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4559 E. BELL ROAD, STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "714-845-8500",
            "fax_number": "303-952-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DENTAL SERVICES FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "DILLENBERG",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Czara Celina Pacheco
• Sonia Maria Pacheco
• Joyce-Nicole Pachence, PA-C
• Sarah Lillian Pachtman, M.D.
• Pacific Biomedical Inc
• Pacific Durable Medical LLC
• Hope Elizabeth Pack, FNP
• Jennifer Lynn Pack, ACNP-BC
• Bruce Paul Packer, M.D.
• Jeffrey Packer, D.O.

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.