Fiesta Kids Dental LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7384 Issued in AZ

Legal business name

FIESTA KIDS DENTAL LLC

Practice address

1303 S Longmore
Suite #1
Mesa, AZ 85202-9607

Phone

(480) 733-5437

Fax

(480) 733-4164

NPI assigned

Apr 12, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Stephen J Montoya, DDS

Title

Owner

Phone

(480) 733-5437

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1770840951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 S LONGMORE",
            "address_2": "SUITE #1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029607",
            "telephone_number": "480-733-5437",
            "fax_number": "480-733-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S LONGMORE",
            "address_2": "SUITE #1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029607",
            "telephone_number": "480-733-5437",
            "fax_number": "480-733-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIESTA KIDS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-733-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "7384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Fiechter, D.O.
• Davis Mark Fiedler, DC
• Jordan Jessica Field
• Nick Fierro
• Fiesta Health Services LLC
• Fiesta Kidtastic, LLC
• Fiesta Pediatric Therapy
• Rachelle Figueroa, NP
• Elena Filatova, O.D
• Mary Eileen Filippone, LAC

• Pediatric Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.