Arizona Dental Health Professionals, P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

ARIZONA DENTAL HEALTH PROFESSIONALS, P.C.

Practice address

5225 E Knight Dr Ste 401
Tucson, AZ 85712-2156

Phone

(520) 809-7703

NPI assigned

Jul 19, 2022

Organization subpart

Yes

Parent organization

ARIZONA DENTAL HEALTH PROFESSIONALS, P.C.As reported in NPPES

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

Authorized official

Name

Courtney R Monteith

Title

Credentialing Coordinator

Phone

(217) 540-8306

Specialties & licenses 1

Addresses

Other names 1

• Southern Arizona Periodontics - Knight Drive Doing business as

Tax ID family

Arizona Dental Health Professionals PC2 organizations share this tax ID, including this one

Part of

Arizona Dental Health Professionals PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Arizona Dental Health Professionals, P.C.

  • Periodontics
  • Tucson, AZ
  • NPI 1629701578
  NPD tax ID

Locations

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1740915248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 E KNIGHT DR STE 401",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 E KNIGHT DR STE 401",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122156",
            "telephone_number": "520-809-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL HEALTH PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL HEALTH PROFESSIONALS, P.C.",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "MONTEITH",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8306"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Arizona Periodontics - Knight Drive",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Arizona Periodontics - Knight Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Arizona Dental Affiliates, PLLC
• Arizona Dental Health Professionals, P.C.
• Arizona Dental Professionals, P.C.
• Arizona Dental Professionals, P.C.
• Arizona Dental Professionals, P.C.
• Arizona Dental Professionals, P.C.
• Arizona Dental Professionals, P.C.

• All providers in Tucson, AZ
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.