NPIMap

Organization Active NPI

Vail Family Dentistry

  • Dental Clinic/Center
  • Vail, AZ
National Provider Identifier
1750861233
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D7579 Issued in AZ
Legal business name
VAIL FAMILY DENTISTRY
Practice address
13190 E Colossal Cave Rd Ste 150
Vail, AZ 85641-8822
Phone
(520) 762-3236
Fax
(520) 762-8058
NPI assigned
Aug 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
Sean Ballew
Title
President
Phone
(520) 762-3236

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Dental Clinic/Center 261QD0000X D7579 AZ Primary

Addresses

Primary practice location

13190 E Colossal Cave Rd Ste 150
Vail, AZ 85641-8822

Mailing address

13190 E Colossal Cave Rd Ste 150
Vail, AZ 85641-8822
Phone (520) 762-3236

National Provider Directory

National Provider Directory

Locations

13190 E Colossal Cave Rd
Ste 150
Vail, AZ 85641
Phone (520) 762-3236

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1750861233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13190 E COLOSSAL CAVE RD STE 150",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856418822",
            "telephone_number": "520-762-3236",
            "fax_number": "520-762-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13190 E COLOSSAL CAVE RD STE 150",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856418822",
            "telephone_number": "520-762-3236",
            "fax_number": "520-762-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIL FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "BALLEW",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-762-3236"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "D7579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.