Sun Lakes Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUN LAKES FAMILY DENTAL LLC

Practice address

10325 E Riggs Rd Ste 109
Sun Lakes, AZ 85248-7647

Phone

(480) 883-8000

NPI assigned

Apr 27, 2023

Last updated

Apr 27, 2023By 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

Jeffrey B Fenn, DMD

Title

Owner/Dentist

Phone

(702) 325-7627

Specialties & licenses 1

Addresses

Locations

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.

• Jaffar M Elahi, DDS MS

  • Prosthodontics
  • Sun Lakes, AZ
  • NPI 1629025960
  NPD (past)
• Ghassan Sheikh Sroujieh, DDS

  • Dentist
  • Sun Lakes, AZ
  • NPI 1366519456
  NPD (past)

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1700574605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 E HUNT HWY STE 101",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435096",
            "telephone_number": "702-325-7627",
            "fax_number": "833-794-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10325 E RIGGS RD STE 109",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487647",
            "telephone_number": "480-883-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LAKES FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "FENN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "702-325-7627",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Staicoff, DPT
• Katelyn Steinken, DPT
• Stephanie Steward, LMSW
• Stuckey Psychological Services, PC
• Sun Lake Optical
• Sun Lakes Family Dentistry,Inc.
• Sun Lakes Family Physicians LLC
• Sun Lakes Fire District
• Sun Lakes Health Care, PC
• Sun Lakes Periodontics & Implant Dentistry, PLLC

• Dental Clinic/Center in Sun Lakes, AZ
• Providers in Sun Lakes, 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 Apr 27, 2023; 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.