NPIMap

Organization Active NPI

Da Vinci Dental Group

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1740714229
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5998 Issued in AZ
Legal business name
DA VINCI DENTAL GROUP
Practice address
1422 W Camelback Rd
Phoenix, AZ 85013-2177
Phone
(602) 336-1111
Fax
(602) 249-3653
NPI assigned
Apr 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Dr. Rachel R Deavila, D.D.S.
Title
Dentist/Owner
Phone
(602) 336-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5998 AZ Primary

Addresses

Primary practice location

1422 W Camelback Rd
Phoenix, AZ 85013-2177

Mailing address

1422 W Camelback Rd
Phoenix, AZ 85013-2177
Phone (602) 336-1111

Other identifiers 1

IdentifierTypeStateIssuer
952673MedicaidAZ

Other names 1

  • Da Vinci Dental Phoenix Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Da Vinci Dental Group2 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.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1740714229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 W CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132177",
            "telephone_number": "602-336-1111",
            "fax_number": "602-249-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 W CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132177",
            "telephone_number": "602-336-1111",
            "fax_number": "602-249-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DA VINCI DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "DEAVILA",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "602-336-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "952673",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Da Vinci Dental Phoenix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.