Arizona Dental Affiliates, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ARIZONA DENTAL AFFILIATES, PLLC

Practice address

2165 W Orange Grove Rd
Tucson, AZ 85741-3118

Phone

(520) 214-5546

NPI assigned

Sep 27, 2022

Organization subpart

No

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

Authorized official

Name

Sibera Troy Brannon, DDS

Title

Owner

Phone

(520) 214-5546

Specialties & licenses 1

Addresses

Other names 1

• Wellness Dental Doing business as

Tax ID family

Arizona Dental Affiliates PLLC2 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.

• Arizona Dental Affiliates, PLLC

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1992428791
  NPD tax ID

Locations

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1750005435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413118",
            "telephone_number": "520-214-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413118",
            "telephone_number": "520-214-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL AFFILIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "SIBERA",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-214-5546",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Tucson, AZ
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.