NPIMap

Organization Active NPI

Paradise Valley Dental Group PC

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1821135732
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AZ4495 Issued in AZ
Legal business name
PARADISE VALLEY DENTAL GROUP PC
Practice address
6865 E. Becker Lane #100
Scottsdale, AZ 85254
Phone
(480) 483-8067
Fax
(480) 483-8471
NPI assigned
Jan 31, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Barry J Nestlerode, DDSNPI 1578894424
Title
Dentist - Owner
Phone
(480) 483-8067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X AZ4495 AZ Primary

Addresses

Primary practice location

6865 E. Becker Lane #100
Scottsdale, AZ 85254

Mailing address

6865 E. Becker Lane #100
Scottsdale, AZ 85254
Phone (480) 483-8067

National Provider Directory

National Provider Directory

Locations

6865 E Becker Ln
Ste 100
Scottsdale, AZ 85254
Phone (480) 483-8067

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1821135732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 E. BECKER LANE #100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85254",
            "telephone_number": "480-483-8067",
            "fax_number": "480-483-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 E. BECKER LANE #100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85254",
            "telephone_number": "480-483-8067",
            "fax_number": "480-483-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE VALLEY DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "NESTLERODE",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST - OWNER",
        "authorized_official_telephone_number": "480-483-8067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "AZ4495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.