NPIMap

Organization Active NPI

Dhew Indian Health Service Health Services & Mental Health Adm.

Doing business as Gila Bend Clinic Dental Services

  • Dentist
  • Gila Bend, AZ
National Provider Identifier
1780730549
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DHEW INDIAN HEALTH SERVICE HEALTH SERVICES & MENTAL HEALTH ADM.
Doing business as
Gila Bend Clinic Dental Services
Practice address
100 North Gila Boulevard
Gila Bend, AZ 85227-2658
Phone
(602) 263-1511
Fax
(602) 263-1619
NPI assigned
Jan 26, 2007
Last updated
Jun 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Authorized official

Name
Miss Deanna J. Dick, MSW., MHA.
Title
(Ceo) Chief Executive Officer
Phone
(602) 263-1567

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary
Public Health Dentistry 1223D0001X
General Practice Dentistry 1223G0001X
Dental Hygienist 124Q00000X
Dental Assistant 126800000X

Addresses

Primary practice location

100 North Gila Boulevard
Gila Bend, AZ 85227-2658

Mailing address

PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1511

Other identifiers 1

IdentifierTypeStateIssuer
812851MedicaidAZ

Other names 1

  • Gila Bend Clinic Dental Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dhew Ind HLTH SV HLTH SVS Mntal HLTH Adm18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1780730549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1511",
            "fax_number": "602-263-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH GILA BOULEVARD",
            "city": "GILA BEND",
            "state": "AZ",
            "postal_code": "852272658",
            "telephone_number": "602-263-1511",
            "fax_number": "602-263-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHEW INDIAN HEALTH SERVICE HEALTH SERVICES & MENTAL HEALTH ADM.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "DICK",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "(CEO) CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-263-1567",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MSW., MHA."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812851",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gila Bend Clinic Dental Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gila Bend, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.