NPIMap

Organization Active NPI

Ideal Dentistry, LTD

  • General Practice Dentistry
  • Peoria, AZ
National Provider Identifier
1902920325
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1564 Issued in AZ
Legal business name
IDEAL DENTISTRY, LTD
Practice address
13360 N 94TH Dr Ste a
Peoria, AZ 85381-4837
Phone
(623) 933-0777
Fax
(623) 933-1464
NPI assigned
Mar 19, 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
Ron Lambert
Title
President
Phone
(602) 569-4933

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 1564 AZ Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6922 AZ

Addresses

Primary practice location

13360 N 94TH Dr Ste a
Peoria, AZ 85381-4837

Mailing address

13360 N 94TH Dr Ste a
Peoria, AZ 85381-4837
Phone (623) 933-0777

National Provider Directory

National Provider Directory

Locations

13360 N 94th Dr
Ste A
Peoria, AZ 85381
Phone (623) 933-0777

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902920325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13360 N 94TH DR STE A",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814837",
            "telephone_number": "623-933-0777",
            "fax_number": "623-933-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13360 N 94TH DR STE A",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814837",
            "telephone_number": "623-933-0777",
            "fax_number": "623-933-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTISTRY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-569-4933"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "1564",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, 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.