Sun Valley Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SUN VALLEY PEDIATRIC DENTISTRY, PLLC

Practice address

10750 W McDowell Rd
Suite F-610
Avondale, AZ 85392-5960

Phone

(622) 347-4290

Fax

(623) 474-2905

NPI assigned

May 29, 2015

Organization subpart

No

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

Authorized official

Name

Jaime Johnson

Title

Controller

Phone

(480) 889-9457

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1881074318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 E SOUTHERN AVE",
            "address_2": "DEPT AVON",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062737",
            "telephone_number": "480-889-9457",
            "fax_number": "480-696-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD",
            "address_2": "SUITE F-610",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925960",
            "telephone_number": "622-347-4290",
            "fax_number": "623-474-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "480-889-9457"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaunna Jean Sukey, PSY.D.
• Riyaz A Sumar, MD
• Steven Rush Sumpter, DO
• Sun Valley Family Practice
• Sun Valley Medical Group
• Sunbridge Healthcare LLC
• Sunny Internal Medicine and Pediatrics, PLLC
• Sunnyside Assisted Living LLC
• Nicole Surdyka, DPT
• Surgical Elite of Avondale, LLC

• Pediatric Dentistry in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.