NPIMap

Organization Active NPI

Canyon Hills Family Dentistry LLC

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1891902003
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CANYON HILLS FAMILY DENTISTRY LLC
Practice address
602 W Union Hills Dr
Suite #8
Phoenix, AZ 85027-6629
Phone
(623) 516-7766
Fax
(623) 516-7788
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ki Ngo, DMD
Title
President Owner
Phone
(480) 917-0181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

602 W Union Hills Dr
Suite #8
Phoenix, AZ 85027-6629

Mailing address

602 W Union Hills Dr
Suite #8
Phoenix, AZ 85027-6629
Phone (623) 516-7766

Other identifiers 1

IdentifierTypeStateIssuer
1778674OtherAZUCCI

Other names 1

  • Canyon Hills Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

602 W Union Hills Dr
Ste 8
Phoenix, AZ 85027
Phone (623) 516-7766

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891902003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W UNION HILLS DR",
            "address_2": "SUITE #8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850276629",
            "telephone_number": "623-516-7766",
            "fax_number": "623-516-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W UNION HILLS DR",
            "address_2": "SUITE #8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850276629",
            "telephone_number": "623-516-7766",
            "fax_number": "623-516-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON HILLS FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "KI",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "480-917-0181",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI",
            "identifier": "1778674",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Hills Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.