NPIMap

Organization Active NPI

Timothy J. Bashara, DMD, PLC

Doing business as Sweet Tooth Pediatric Dentistry

  • Pediatric Dentistry
  • Gilbert, AZ
National Provider Identifier
1871707836
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D5688 Issued in AZ
Legal business name
TIMOTHY J. BASHARA, DMD, PLC
Doing business as
Sweet Tooth Pediatric Dentistry
Practice address
5656 S. Power Rd.
Ste. 118
Gilbert, AZ 85295
Phone
(480) 988-1879
Fax
(480) 988-4690
NPI assigned
May 9, 2007
Last updated
Sep 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. Timothy J Bashara, DMDNPI 1285753574
Title
Owner, Dentist
Phone
(480) 988-1879

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D5688 AZ Primary

Addresses

Primary practice location

5656 S. Power Rd.
Ste. 118
Gilbert, AZ 85295

Mailing address

5656 S. Power Rd.
Ste. 118
Gilbert, AZ 85295
Phone (480) 988-1879

Other identifiers 2

IdentifierTypeStateIssuer
718794MedicaidAZ
718794OtherAZAHCCCS PROVIDER NUMBER

Other names 1

  • Sweet Tooth Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

5656 S Power Rd
Ste 118
Gilbert, AZ 85295
Phone (480) 988-1879

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1871707836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 S. POWER RD.",
            "address_2": "STE. 118",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85295",
            "telephone_number": "480-988-1879",
            "fax_number": "480-988-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 S. POWER RD.",
            "address_2": "STE. 118",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85295",
            "telephone_number": "480-988-1879",
            "fax_number": "480-988-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY J. BASHARA, DMD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "BASHARA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "480-988-1879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D5688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718794",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER NUMBER",
            "identifier": "718794",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sweet Tooth Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.