My Scottsdale Dentist

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MY SCOTTSDALE DENTIST

Practice address

9070 E Desert Cove Ave
Suite 105
Scottsdale, AZ 85260-6227

Phone

(480) 614-1122

Fax

(480) 614-1226

NPI assigned

Jan 8, 2016

Organization subpart

No

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

Authorized official

Name

Steven H. Poulos, D.D.S.

Title

Dentist

Phone

(480) 614-1122

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1831555622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 E DESERT COVE AVE",
            "address_2": "SUITE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606227",
            "telephone_number": "480-614-1122",
            "fax_number": "480-614-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 E DESERT COVE AVE",
            "address_2": "SUITE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606227",
            "telephone_number": "480-614-1122",
            "fax_number": "480-614-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SCOTTSDALE DENTIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "POULOS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-614-1122",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.