Desert Lily Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DESERT LILY DENTAL

Practice address

12020 N 35TH Ave Ste 2
Phoenix, AZ 85029-3213

Phone

(435) 637-2100

NPI assigned

Feb 15, 2021

Organization subpart

No

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

Authorized official

Name

Tiffany Bray

Title

Manager

Phone

(435) 637-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1750974382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 N 35TH AVE STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 N 35TH AVE STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293213",
            "telephone_number": "435-637-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT LILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "435-637-2100"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "586868",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desert Injury Group, LLC
• Desert Institute for Spine Care PC
• Desert Institute of Classical Homeopathy
• Desert IV Therapy PLLC (PERLA Bienestar Center)
• Desert Kids Pediatrics PLC
• Desert Lily Healthcare, Inc.
• Desert Living Assisted Living LLC
• Desert Medical Billing and Consulting Services, Inc (DMB Medical Imaging)
• Desert Mercy Diabetes and Thyroid Center PLLC
• Desert Mission Inc (Marley House)

• Dental Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.