Mirror Image Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MIRROR IMAGE DENTAL LLC

Practice address

4710 E Cactus Rd
Phoenix, AZ 85032-7706

Phone

(480) 442-0225

NPI assigned

Mar 11, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Shawn Michael Maule, DDSNPI 1386242691

Title

Ceo / Owner Dentist

Phone

(602) 705-9168

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.

• Shawn Maule, DDS

  • Dentist
  • Phoenix, AZ
  • NPI 1386242691
  NPD Authorized official
• Shane Michael Maule, DDS

  • Dentist
  • Buckeye, AZ
  • NPI 1790382968
  NPD (past)

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1891594016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E POTTER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244334",
            "telephone_number": "602-705-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 E CACTUS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327706",
            "telephone_number": "480-442-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRROR IMAGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "MAULE",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO / OWNER DENTIST",
        "authorized_official_telephone_number": "602-705-9168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mireille Wellness Clinic
• Angelica Mireles, CPNP
• Mandalene Jayne Mirkhah, DDS
• Kayla Lauren Miro, LPC
• Joshua Mirrer, MD
• Zaman Zacharya Mirzadeh, MD, PHD
• Annasharena Mirzaee
• Thomas Mirzai, D.O.
• Maryann Mirzakandov
• Nicole C Mis, FNP

• Dental Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.