NPIMap

Organization Active NPI

Arizona Dental Professionals, P.C.

Doing business as Smiles on Southern

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1780995159
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Doing business as
Smiles on Southern
Practice address
5432 E Southern Ave Ste 108
Mesa, AZ 85206-2772
Phone
(480) 807-8100
Fax
(480) 325-8014
NPI assigned
Jun 30, 2010
Last updated
Feb 4, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Carmen Woods
Title
Insurance Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5432 E Southern Ave Ste 108
Mesa, AZ 85206-2772

Mailing address

5432 E Southern Ave Ste 108
Mesa, AZ 85206-2772
Phone (480) 807-8100

Other names 1

  • Smiles on Southern Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Detnal Care of Arizona PC63 organizations share this tax ID, including this one
Part of
Heartland Detnal Care of Arizona PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5432 E Southern Ave
Ste 108
Mesa, AZ 85206
Phone (480) 210-3336

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1780995159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5432 E SOUTHERN AVE STE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062772",
            "telephone_number": "480-807-8100",
            "fax_number": "480-325-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5432 E SOUTHERN AVE STE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062772",
            "telephone_number": "480-807-8100",
            "fax_number": "480-325-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2010-06-30",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles on Southern",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.