Az Dental Laboratory LLC

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

AZ DENTAL LABORATORY LLC

Practice address

15028 W Jackpot Way
Surprise, AZ 85374-4439

Phone

(602) 802-9751

NPI assigned

May 18, 2020

Organization subpart

No

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

Authorized official

Name

Kristina Flit

Title

Owner

Phone

(517) 420-2303

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589760000000",
    "number": "1902428527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9847 W MOHAWK LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822293",
            "telephone_number": "517-420-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15028 W JACKPOT WAY",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744439",
            "telephone_number": "602-802-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ DENTAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A",
        "authorized_official_last_name": "FLIT",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-420-2303"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Laboratory in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dental Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.