Prescott Periodontics & Implant Dentistry, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PRESCOTT PERIODONTICS & IMPLANT DENTISTRY, PLLC

Practice address

1229 Willow Creek Rd
Prescott, AZ 86301-1427

Phone

(928) 778-2340

Fax

(928) 778-3646

NPI assigned

Sep 26, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Richard Charles Jirsa, D.D.S, M.S.NPI 1093775488

Title

Periodontist

Phone

(928) 778-2340

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Richard C. Jirsa, DDS

  • Periodontics
  • Prescott, AZ
  • NPI 1093775488
  NPD (past) Authorized official
• Todd W Walker, D.M.D., M.S.

  • Periodontics
  • Prescott, AZ
  • NPI 1134449481
  NPD (past)

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1891244281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011427",
            "telephone_number": "928-778-2340",
            "fax_number": "928-778-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011427",
            "telephone_number": "928-778-2340",
            "fax_number": "928-778-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT PERIODONTICS & IMPLANT DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "JIRSA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "928-778-2340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S, M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prescott Pulmonary and Sleep Specialists, PLLC
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• Prescott Radiologists LLP
• Prescott Recovery Services LLC
• Prescott Relationship Center, PLLC

• Periodontics in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.