Chandler PDC PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHANDLER PDC PLLC

Practice address

3800 W Ray Rd Ste 11
Chandler, AZ 85226-5940

Phone

(480) 345-0530

NPI assigned

Mar 14, 2024

Organization subpart

No

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

Authorized official

Name

Mark Christensen

Title

Credentialing Specialist

Phone

(801) 305-3460

Specialties & licenses 1

Addresses

Other names 1

• Johansen Dental Doing business as

Locations

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1891554705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 S 520 W STE 250",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421976",
            "telephone_number": "801-305-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-345-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDLER PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johansen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chandler Orthopedic Center LLC
• Chandler Pain Medicine & Physical Therapy, LLC
• Chandler Pediatrics LLC
• Chandler Physiatry
• Chandler Primary Care PLC
• Chandler Procedure Center, PLC
• Chandler Radiology Associates LLC

• General Practice Dentistry in Chandler, AZ
• Providers in Chandler, 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 Mar 14, 2024; 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.