Az Max Dental Implants PLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

AZ MAX DENTAL IMPLANTS PLC

Practice address

6755 E Superstition Springs Blvd Ste 103
Mesa, AZ 85206-4375

Phone

(480) 830-5866

Fax

(480) 807-0606

NPI assigned

Sep 21, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Brent R Boyse, DDS

Title

Manager

Phone

(480) 830-5866

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1760098123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 E SUPERSTITION SPRINGS BLVD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064375",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 E SUPERSTITION SPRINGS BLVD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064375",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7350 S McClintock Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852835006",
            "country_code": "US",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AZ MAX DENTAL IMPLANTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "BOYSE",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-830-5866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.