Organization Active NPI

Michael J Killebrew DDS & Associates PLLC

  • Dental Clinic/Center
  • Tucson, AZ
National Provider Identifier
1710001797
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2339 Issued in AZ
Legal business name
MICHAEL J KILLEBREW DDS & ASSOCIATES PLLC
Doing business as
Michael Killebrew
Practice address
63675 E Saddlebrooke Blvd
Ste. M
Tucson, AZ 85739-1297
Phone
(520) 818-6732
Fax
(520) 818-7824
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Michael J Killebrew, DDS
Title
President
Phone
(520) 401-4191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2339 AZ Primary

Addresses

Primary practice location

63675 E Saddlebrooke Blvd
Ste. M
Tucson, AZ 85739-1297

Mailing address

8753 E Honeybear PL
Tucson, AZ 85749-8202
Phone (520) 401-4191

Other names 1

  • Michael Killebrew Doing business as

National Provider Directory

National Provider Directory

Locations

63675 E Saddlebrooke Blvd
Ste M
Tucson, AZ 85739
Phone (520) 818-6732

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1710001797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8753 E HONEYBEAR PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857498202",
            "telephone_number": "520-401-4191",
            "fax_number": "520-760-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63675 E SADDLEBROOKE BLVD",
            "address_2": "STE. M",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857391297",
            "telephone_number": "520-818-6732",
            "fax_number": "520-818-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J KILLEBREW DDS & ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "KILLEBREW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-401-4191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "2339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Killebrew",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.