NPIMap

Organization Active NPI

Maricopa Family Dental LLC

  • General Practice Dentistry
  • Maricopa, AZ
National Provider Identifier
1831731587
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MARICOPA FAMILY DENTAL LLC
Practice address
20046 N. John Wayne Pkwy
Suite 105
Maricopa, AZ 85139
Phone
(520) 316-6100
Fax
(520) 568-7312
NPI assigned
Oct 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Authorized official

Name
Faith Gaskins
Title
Director of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

20046 N. John Wayne Pkwy
Suite 105
Maricopa, AZ 85139

Mailing address

20046 N. John Wayne Pkwy
Suite 105
Maricopa, AZ 85139
Phone (520) 316-6100

National Provider Directory

National Provider Directory

Locations

20046 N John Wayne Pkwy
Ste 105
Maricopa, AZ 85139
Phone (520) 316-6100

Practitioners & affiliated clinicians

Practitioners 2

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": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1831731587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20046 N. JOHN WAYNE PKWY",
            "address_2": "SUITE 105",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "85139",
            "telephone_number": "520-316-6100",
            "fax_number": "520-568-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20046 N. JOHN WAYNE PKWY",
            "address_2": "SUITE 105",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "85139",
            "telephone_number": "520-316-6100",
            "fax_number": "520-568-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maricopa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.