Desert Ridge Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5548 Issued in AZ

Legal business name

DESERT RIDGE PEDIATRIC DENTISTRY

Practice address

5315 E. High Street
Suite 115
Phoenix, AZ 85054

Phone

(480) 585-5868

Fax

(480) 585-1208

NPI assigned

Oct 26, 2007

Last updated

Jul 17, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lidieth R Libby, D.D.S.NPI 1518062405

Title

Owner

Phone

(480) 585-5868

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Lidieth Libby, D.D.S.

  • Pediatric Dentistry
  • Phoenix, AZ
  • NPI 1518062405
  Authorized official Same address or phone
• Robert G Cox, DDS

  • Pediatric Dentistry
  • Glendale, AZ
  • NPI 1407389869
  NPD (past)

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1811176860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 E HIGH ST",
            "address_2": "SUITE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850545438",
            "telephone_number": "480-585-5868",
            "fax_number": "480-585-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 E. HIGH STREET",
            "address_2": "SUITE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "480-585-5868",
            "fax_number": "480-585-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT RIDGE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "LIBBY",
        "authorized_official_first_name": "LIDIETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-585-5868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "5548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "632481",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desert Ridge Medical Group Anesthesia LLC
• Desert Ridge Medical LLC
• Desert Ridge Oral,Facial & Implant Surgery, PLLC
• Desert Ridge Outpatient Surgery LLC
• Desert Ridge Pain Facility
• Desert Ridge Prosthodontics
• Desert Ridge Surgical Specialists, LLC
• Desert Ridge Urgent Care LLC (NextCare)
• Desert Run Multispecialty PLC
• Desert Sage Family Dental

• Dental Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.