Santan Kidtastic LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SANTAN KIDTASTIC LLC

Practice address

2510 E Hunt Hwy Ste 29
San Tan Valley, AZ 85143-5208

Phone

(480) 648-4037

Fax

(480) 696-5505

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Jaime Johnson

Title

Controll

Phone

(480) 648-4037

Specialties & licenses 1

Addresses

Other names 1

• SanTan Kidtastics Doing business as

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1669726030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062737",
            "telephone_number": "480-648-4037",
            "fax_number": "480-696-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY STE 29",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435208",
            "telephone_number": "480-648-4037",
            "fax_number": "480-696-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTAN KIDTASTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "CONTROLL",
        "authorized_official_telephone_number": "480-648-4037",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SanTan Kidtastics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Salter
• Janelle T Sammy, SOCIAL WORKER, LMSW
• San Tan Mountain Chiropractic and Rehab, LLC
• San Tan Primary Care PC
• San Tan Valley Oral Facial and Implant Surgery PLLC
• Michelle M Santos, LMT
• Ashley Dawn Savage, CPHT VT
• Save US Foundation
• Abraham Joseph Sayegh, M.D.
• Lisa Kay Scarpa

• Pediatric Dentistry in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.