Organization Active NPI

Arizona Dental Professionals, P.C.

Doing business as Gavilan Peak Dental Care

  • General Practice Dentistry
  • Anthem, AZ
National Provider Identifier
1720862295
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Doing business as
Gavilan Peak Dental Care
Practice address
2355 W Anthem Way
Anthem, AZ 85086-4959
Phone
(623) 303-4110
Fax
(623) 303-4112
NPI assigned
Aug 24, 2023
Last updated
Aug 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

2355 W Anthem Way
Anthem, AZ 85086-4959

Mailing address

2355 W Anthem Way
Anthem, AZ 85086-4959
Phone (623) 303-4110

Other names 1

  • Gavilan Peak Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Frank Nelson DDS PC63 organizations share this tax ID, including this one
Part of
Frank Nelson DDS PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2355 W Anthem Way
Anthem, AZ 85086
Phone (623) 303-4110

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1720862295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 W ANTHEM WAY",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850864959",
            "telephone_number": "623-303-4110",
            "fax_number": "623-303-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 W ANTHEM WAY",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850864959",
            "telephone_number": "623-303-4110",
            "fax_number": "623-303-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gavilan Peak Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anthem, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.