NPIMap

Organization Active NPI

Arizona Dental Professionals, P.C.

Doing business as Village Grove Dental Care

  • General Practice Dentistry
  • Buckeye, AZ
National Provider Identifier
1659875698
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Doing business as
Village Grove Dental Care
Practice address
4120 N 197TH Ave
Buckeye, AZ 85396
Phone
(480) 696-8353
NPI assigned
Mar 23, 2018
Last updated
Oct 3, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-8426

Specialties & licenses 1

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

Addresses

Primary practice location

4120 N 197TH Ave
Buckeye, AZ 85396

Mailing address

4120 N 197TH Ave
Buckeye, AZ 85396-8428
Phone (623) 289-1873

Other practice location 1

4120 N 19th Ave
Buckeye, AZ 85396-8428
Phone (480) 696-8353

Other names 1

  • Village Grove Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Detnal Care of Arizona PC63 organizations share this tax ID, including this one
Part of
Heartland Detnal Care of Arizona PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4120 N 197th Ave
Buckeye, AZ 85396
Phone (480) 696-8353

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 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1659875698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 N 197TH AVE",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853968428",
            "telephone_number": "623-289-1873",
            "fax_number": "623-289-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 N 197TH AVE",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "85396",
            "telephone_number": "480-696-8353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4120 N 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Buckeye",
            "state": "AZ",
            "postal_code": "853968428",
            "country_code": "US",
            "telephone_number": "480-696-8353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8426"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Grove Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Grove Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.