NPIMap

Organization Active NPI

Dental Depot Ortho Greenway PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Phoenix, AZ
National Provider Identifier
1760076145
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
DENTAL DEPOT ORTHO GREENWAY PLLC
Practice address
3750 W Greenway Rd
Phoenix, AZ 85053-3703
Phone
(602) 466-2202
NPI assigned
Feb 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Ruth Martinez
Title
Regional Manager
Phone
(602) 312-2752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

3750 W Greenway Rd
Phoenix, AZ 85053-3703

Mailing address

2828 NW 30TH St
Oklahoma City, OK 73112-7404
Phone (602) 312-2752

Other names 1

  • Glenn A Ashmore DDS Sole MBR Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mail.dentaldepot.net

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1760076145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127404",
            "telephone_number": "602-312-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 W GREENWAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850533703",
            "telephone_number": "602-466-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT ORTHO GREENWAY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "602-312-2752"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mail.dentaldepot.net",
            "affiliation": "N",
            "address_1": "2828 NW 30th St",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731127404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Glenn A Ashmore DDS Sole MBR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.