NPIMap

Organization Active NPI

Prescott Valley PDC PLLC

  • General Practice Dentistry
  • Prescott Valley, AZ
National Provider Identifier
1720827652
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRESCOTT VALLEY PDC PLLC
Practice address
7890 E Florentine Rd
Prescott Valley, AZ 86314-1204
Phone
(928) 772-9860
NPI assigned
May 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Mark Christensen
Title
Credentialing Specialist
Phone
(801) 305-3460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7890 E Florentine Rd
Prescott Valley, AZ 86314-1204

Mailing address

355 S 520 W Ste 250
Lindon, UT 84042-1976

Other names 1

  • Horizon Dental Doing business as

National Provider Directory

National Provider Directory

Locations

7890 E Florentine Rd
Prescott Vly, AZ 86314
Phone (928) 350-8869

Practitioners & affiliated clinicians

Practitioners 5

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": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1720827652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 S 520 W STE 250",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7890 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141204",
            "telephone_number": "928-772-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT VALLEY PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott Valley, AZ

Sources for this page

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