NPIMap

Organization Active NPI

Arizona Dental Professionals, P.C.

  • General Practice Dentistry
  • Buckeye, AZ
National Provider Identifier
1851992879
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Practice address
1177 S Watson Rd Ste 107
Buckeye, AZ 85326-3465
Phone
(623) 244-0636
Fax
(623) 235-6308
NPI assigned
Nov 5, 2020
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

1177 S Watson Rd Ste 107
Buckeye, AZ 85326-3465

Mailing address

1177 S Watson Rd Ste 107
Buckeye, AZ 85326-3465
Phone (623) 244-0636

Other names 1

  • Dental Care on Watson Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arizona Dental Professionals PC63 organizations share this tax ID, including this one
Part of
Arizona Dental Professionals PC

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

1177 S Watson Rd
Ste 107
Buckeye, AZ 85326
Phone (623) 244-0636

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 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": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1851992879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 S WATSON RD STE 107",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263465",
            "telephone_number": "623-244-0636",
            "fax_number": "623-235-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 S WATSON RD STE 107",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263465",
            "telephone_number": "623-244-0636",
            "fax_number": "623-235-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care on Watson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Care on Watson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.