NPIMap

Organization Active NPI

Pdo LLC

  • General Practice Dentistry
  • Saint Clair, MI
National Provider Identifier
1750712642
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PDO LLC
Practice address
4146 Neuman Rd
Saint Clair, MI 48079-3234
Phone
(480) 775-8600
NPI assigned
Dec 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Authorized official

Name
Jared Pope, DDS
Title
Owner
Phone
(480) 332-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4146 Neuman Rd
Saint Clair, MI 48079-3234

Mailing address

2995 W Elliot Rd
Ste 1
Chandler, AZ 85224-1670
Phone (480) 775-8600

National Provider Directory

National Provider Directory
Tax ID family
Pdo LLC2 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.

Locations

2995 W Elliot Rd
Ste 1
Chandler, AZ 85224
Phone (480) 775-8600

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1750712642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 W ELLIOT RD",
            "address_2": "STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241670",
            "telephone_number": "480-775-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4146 NEUMAN RD",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480793234",
            "telephone_number": "480-775-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-332-6111",
        "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": []
}

Other providers in Saint Clair, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.