Palo Verde Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6412 Issued in AZ

Legal business name

PALO VERDE DENTISTRY

Practice address

3400 N. Dysart Rd
Ste G125
Avondale, AZ 85392

Phone

(623) 322-9215

Fax

(623) 322-9251

NPI assigned

Jan 22, 2013

Organization subpart

No

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

Authorized official

Name

Thihan Phan, DDSNPI 1750429619

Title

Dentist

Phone

(623) 322-9215

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.

• Thihan Phan, DDS

  • General Practice Dentistry
  • Avondale, AZ
  • NPI 1750429619
  NPD (past) Authorized official

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1730427006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N. DYSART RD",
            "address_2": "STE G125",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "85392",
            "telephone_number": "623-322-9215",
            "fax_number": "623-322-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N. DYSART RD",
            "address_2": "STE G125",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "85392",
            "telephone_number": "623-322-9215",
            "fax_number": "623-322-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO VERDE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "THIHAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "623-322-9215",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "6412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Paine, MS, BCBA, LBA
• Palm Valley Family Dentistry Inc
• Palm Valley Women'S Care
• Ezekiel George Palmani
• Riley Palmer III
• Brenda Jean Paluc, PH.D.
• Elisa Panduro Beltran
• Sydney Pape
• Ruben Paramo
• Brianna Mari Parker, SLP-CF

• Dental Clinic/Center in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.