Organization Active NPI

NSN Dental, PLLC

  • Endodontics
  • Avondale, AZ
National Provider Identifier
1821698622
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
NSN DENTAL, PLLC
Practice address
10750 W McDowell Rd Ste A250
Avondale, AZ 85392-5979
Phone
(623) 907-9400
Fax
(623) 907-9405
NPI assigned
Oct 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Nicholas Netzel, DMDNPI 1164860755
Title
President
Phone
(623) 910-2767

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

10750 W McDowell Rd Ste A250
Avondale, AZ 85392-5979

Mailing address

6243 W Kristal Way
Glendale, AZ 85308-7661

Other identifiers 1

IdentifierTypeStateIssuer
1164860755OtherENDODONTIST

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Avondaleendo@outlook.com

National Provider Directory

National Provider Directory

Locations

10750 W McDowell Rd
Ste A250
Avondale, AZ 85392
Phone (623) 907-9400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1821698622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6243 W KRISTAL WAY",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD STE A250",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925979",
            "telephone_number": "623-907-9400",
            "fax_number": "623-907-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NSN DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "NETZEL",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-910-2767",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENDODONTIST",
            "identifier": "1164860755",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Avondaleendo@outlook.com",
            "affiliation": "N",
            "address_1": "10750 W McDowell Rd Ste A250",
            "city": "Avondale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853925979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.