Summit Dental Specialty PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D9064 Issued in AZ

Legal business name

SUMMIT DENTAL SPECIALTY PLLC

Practice address

15810 S 45TH St Ste 120
Phoenix, AZ 85048-7695

Phone

(480) 893-3636

Fax

(480) 893-3635

NPI assigned

Aug 10, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shiela Dominguez

Title

Managing Member

Phone

(480) 669-6419

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Hardie Wheelock, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • El Paso, TX
  • NPI 1104453075
  NPD

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871018887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15810 S 45TH ST STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487695",
            "telephone_number": "480-893-3636",
            "fax_number": "480-893-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 S 45TH ST STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487695",
            "telephone_number": "480-893-3636",
            "fax_number": "480-893-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL SPECIALTY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "SHIELA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-669-6419"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D9064",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "AZ",
            "license": "D06147",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn B. Summers, M.D.
• Summit Anesthesia Pain Services PLLC
• Summit Anesthesia Partners
• Summit Anesthesia Services PLLC
• Summit Anesthesia Solutions PLLC
• Summit Health, LLC
• Summit Hip and Knee Institute LLC
• Summit Home Health LLC (Summit Home Health)
• Summit Home Wellness LLC
• Summit Institute of Illinois LLC

• Endodontics in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Endodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.