MBDT Dental Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D008789 Issued in AZ

Legal business name

MBDT DENTAL INC

Doing business as

Half Dental Tucson

Practice address

5577 N Oracle Rd
Suite 101
Tucson, AZ 85704-3877

Phone

(520) 777-0616

NPI assigned

Jan 21, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Robert James Houchin, DDS

Title

President

Phone

(909) 576-3999

Specialties & licenses 1

Addresses

Other names 1

• Half Dental Tucson Doing business as

Tax ID family

Half Dental Tucson2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Half Dental Tucson, Inc.

  • Dental Clinic/Center
  • Tucson, AZ
  • NPI 1619319001
  NPD tax ID

Locations

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1699164103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5577 N ORACLE RD",
            "address_2": "SUITE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043877",
            "telephone_number": "520-777-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5577 N ORACLE RD",
            "address_2": "SUITE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043877",
            "telephone_number": "520-777-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBDT DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "HOUCHIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-576-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "D008789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Half Dental Tucson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Mazzarella, M.S, PH.D
• David J Mazzola Jr., SA-C
• David John Mazzola
• Samantha Mazzucco, PT, DPT
• MB Wenzel
• Mbi Occupational Heathcare Tucson
• Fredrick Mbinga, PTA
• Teri Marie MC Clemons, EDS
• John Houston MC Laughlin, DC
• Rebecca M. McAllister, PT

• Dental Clinic/Center in Tucson, AZ
• Providers in Tucson, 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 Jan 21, 2015; 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.