NPIMap

Organization Active NPI

Coppermine Dental Studio at Madera Canyon PLLC

  • Dentist
  • Green Valley, AZ
National Provider Identifier
1811479074
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COPPERMINE DENTAL STUDIO AT MADERA CANYON PLLC
Practice address
685 S Pecan Tree LN
Green Valley, AZ 85614-5114
Phone
(520) 625-1600
NPI assigned
Sep 4, 2018
Last updated
Sep 4, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
JUSTIN DUTTON DMD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Authorized official

Name
Dr. Justin Dutton, DMDNPI 1033186556
Title
Managing Member
Phone
(520) 839-0600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

685 S Pecan Tree LN
Green Valley, AZ 85614-5114

Mailing address

685 S Pecan Tree LN
Green Valley, AZ 85614-5114
Phone (520) 625-1600

National Provider Directory

National Provider Directory
Part of
Justin Dutton DMD PC

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.

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": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1811479074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 S PECAN TREE LN",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145114",
            "telephone_number": "520-625-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 S PECAN TREE LN",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145114",
            "telephone_number": "520-625-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPERMINE DENTAL STUDIO AT MADERA CANYON PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JUSTIN DUTTON DMD PC",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "DUTTON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "520-839-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.