NPIMap

Organization Active NPI

Surprise Family Dentistry

  • Dentist
  • Surprise, AZ
National Provider Identifier
1679933154
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D05975 Issued in AZ
Legal business name
SURPRISE FAMILY DENTISTRY
Practice address
18775 N Reems Rd Ste 300
Surprise, AZ 85374-8647
Phone
(623) 556-5510
NPI assigned
Feb 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Authorized official

Name
Dr. Shreedevi Thulasidas, DDS MS
Title
Dentist
Phone
(623) 556-5510

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D07677 AZ
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D05975 AZ Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D07677 AZ
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D05975 AZ
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X D07677 AZ

Addresses

Primary practice location

18775 N Reems Rd Ste 300
Surprise, AZ 85374-8647

Mailing address

18775 N Reems Rd Ste 300
Surprise, AZ 85374-8647
Phone (623) 556-5510

Other names 1

  • Surprise Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1679933154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18775 N REEMS RD STE 300",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748647",
            "telephone_number": "623-556-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18775 N REEMS RD STE 300",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748647",
            "telephone_number": "623-556-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "THULASIDAS",
        "authorized_official_first_name": "SHREEDEVI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "623-556-5510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D07677",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D05975",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D07677",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D05975",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "AZ",
            "license": "D07677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surprise Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.