NPIMap

Organization Active NPI

Canyon Lakes Dental Group and Orthodontics, LLP

Doing business as Canyon Lakes Dental and Orthodontics

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1730418468
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CANYON LAKES DENTAL GROUP AND ORTHODONTICS, LLP
Doing business as
Canyon Lakes Dental and Orthodontics
Practice address
2025 N Power Rd
Suite 101
Mesa, AZ 85215-2913
Phone
(480) 964-1560
Fax
(480) 325-1229
NPI assigned
Dec 8, 2009
Last updated
Dec 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Authorized official

Name
Dr. Robert J Seymour, DMD
Title
Owner
Phone
(480) 964-1560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

2025 N Power Rd
Suite 101
Mesa, AZ 85215-2913

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 368-2077

Other names 1

  • Canyon Lakes Dental and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

2025 N Power Rd
Ste 101
Mesa, AZ 85215
Phone (480) 964-1560

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1730418468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 N POWER RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152913",
            "telephone_number": "480-964-1560",
            "fax_number": "480-325-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON LAKES DENTAL GROUP AND ORTHODONTICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "SEYMOUR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-964-1560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Lakes Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.