East River Road Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EAST RIVER ROAD DENTAL LLC

Practice address

1640 E River Rd Ste 112
Tucson, AZ 85718-7645

Phone

(520) 299-4470

NPI assigned

Aug 9, 2022

Organization subpart

No

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

Authorized official

Name

Vicenta Reyes

Title

Credentialing Manager

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Riverside Dental Doing business as

Practitioners 2

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

• Grant David Hooper, DDS

  • Dentist
  • Tucson, AZ
  • NPI 1528692431

  General Practice

  NPD
• Jason Kent Kirkland, D.D.S.

  • General Practice Dentistry
  • Tucson, AZ
  • NPI 1689692899
  NPD (past)

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1902534829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 E RIVER RD STE 112",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857187645",
            "telephone_number": "520-299-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E RIVER RD STE 112",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857187645",
            "telephone_number": "520-299-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST RIVER ROAD DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "VICENTA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "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": "Riverside Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Earp, M.D.
• Leo Easley II, NURSE PRACTITIONER
• East 22ND Street Dental, P.C.
• East 22ND Street Dental, P.C.
• East Fort Lowell Dental, LLC
• East Tucson Care Homes, LLC
• East Tucson Im & Geriatrics, Inc
• East Valley Surgical Services, LLC
• Rylan D East, PA-C
• Easter Seals Blake Foundation

• General Practice Dentistry in Tucson, AZ
• Providers in Tucson, 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 Aug 9, 2022; 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.