Pali, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D008569 Issued in AZ

Legal business name

PALI, LLC

Practice address

5511 W Glendale Ave
Glendale, AZ 85301-2522

Phone

(623) 937-9241

NPI assigned

Oct 17, 2016

Organization subpart

No

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

Authorized official

Name

Charisma Luat, DDS

Title

Dentist/Owner

Phone

(623) 937-9241

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Pali LLC2 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.

• Pali, LLC

  • Dentist
  • Glendale, AZ
  • NPI 1982038949
  NPD tax ID

Locations

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1710438676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012522",
            "telephone_number": "623-937-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012522",
            "telephone_number": "623-937-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "LUAT",
        "authorized_official_first_name": "CHARISMA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "623-937-9241",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120792",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sai Sravanthi Palakodety, MD
• Elliot Palay, LCSW
• Mark Steven Palazzo, DC
• Pauline Paleo, LPN
• Frances Mariel Palermo Alvarado, MD
• Pali, LLC
• Kendra Lee Palmer, M.A. CFY-SLP
• Richard Palmer
• Tristan Palmer
• Aaron Palmieri, D.C.

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, 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 15, 2024; 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.