Anthem Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5002 Issued in AZ

Legal business name

ANTHEM DENTAL, LLC

Doing business as

Classical Dentistry of Arizona

Practice address

41111 N Daisy Mountain Dr
Suite 105
Anthem, AZ 85086-4957

Phone

(623) 551-5444

Fax

(623) 551-2522

NPI assigned

Aug 4, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Fawne E Pryor

Title

Insurance Manager

Phone

(480) 619-7023

Specialties & licenses 1

Addresses

Other names 1

• Classical Dentistry of Arizona Doing business as

Locations

Practitioners 1

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

• Robert Bradley Kohl, DDS

  • General Practice Dentistry
  • Anthem, AZ
  • NPI 1336229426
  NPD (past)

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1861658304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41111 N DAISY MOUNTAIN DR",
            "address_2": "SUITE 105",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850864957",
            "telephone_number": "623-551-5444",
            "fax_number": "623-551-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41111 N DAISY MOUNTAIN DR",
            "address_2": "SUITE 105",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850864957",
            "telephone_number": "623-551-5444",
            "fax_number": "623-551-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "FAWNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "480-619-7023",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Classical Dentistry of Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angel Pediatrics PLLC
• Ann Marie D'Onofrio (None)
• Anthem Center for Oral Facial Surgery PC
• Anthem Counseling, LLC
• Anthem Dental Care
• Anthem Dentist
• Anthem Dentistry LLC
• Anthem Endo PLLC (Anthem Endodontics)
• Anthem Endodontics PLLC
• Anthem Eye Care PC (Better Vision)

• General Practice Dentistry in Anthem, AZ
• Providers in Anthem, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.