Abc Pediatric Dental Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6361 Issued in AZ

Legal business name

ABC PEDIATRIC DENTAL PROFESSIONAL CORPORATION

Practice address

16222 W Boca Raton Rd
Surprise, AZ 85379-5073

Phone

(801) 448-2346

NPI assigned

Mar 27, 2014

Last updated

Mar 27, 2014By 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

Dr. Benjamin Menlove, DDSNPI 1487710174

Title

President

Phone

(801) 448-2346

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Benjamin Menlove, DDS

  • General Practice Dentistry
  • Lubbock, TX
  • NPI 1487710174
  Authorized official Same address or phone

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1710304654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850313728",
            "telephone_number": "801-448-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16222 W BOCA RATON RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795073",
            "telephone_number": "801-448-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PEDIATRIC DENTAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "MENLOVE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-448-2346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Golden Retreat Care Home, LLC (A Golden Retreat Care Home)
• A Loving Heart Assisted Living II
• A New Day Counseling Center LLC
• A. Clark Ruttinger D O PLLC
• Aag Serenity Servives, LLC
• Aseel Sliwa Abdulahad, MD
• Christina Abedi, PHARM. D.
• Courtney Abernathy
• Katherine Abina, OTR/L
• About Seniors Assisted Living Home, LLC

• General Practice Dentistry in Surprise, AZ
• Providers in Surprise, 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 Mar 27, 2014; 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.