Lake Havasu City Valley Dental Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC

Practice address

1939 McCulloch Blvd N
Ste 2
Lake Havasu City, AZ 86403-5652

Phone

(928) 855-5041

Fax

(928) 855-2757

NPI assigned

Jul 16, 2006

Last updated

Jul 21, 2022By 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

Mrs. Betty Ann Horn

Title

Administrative Director

Phone

(928) 855-5041

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699792788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MCCULLOCH BLVD",
            "address_2": "#2",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "928-855-5041",
            "fax_number": "928-855-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 MCCULLOCH BLVD N",
            "address_2": "STE 2",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035652",
            "telephone_number": "928-855-5041",
            "fax_number": "928-855-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "928-855-5041",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Laser Center PC, a Professional Medical Corporation
• Laboratory Corporation of America
• Lake Havasu Anesthesia LLC
• Lake Havasu Chiropractic
• Lake Havasu City
• Lake Havasu Community Health Center LLC (Lake havasu community health center)
• Lake Havasu Dentistry (Havasu Dentistry)
• Lake Havasu Family Eyecare, LLC
• Lake Havasu Imaging Center Inc
• Lake Havasu Medical Laboratory,LTD.

• General Practice Dentistry in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.