Organization Active NPI

WSG Dental Development, LLC

  • Dentist
  • Tucson, AZ
National Provider Identifier
1922123363
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5988 Issued in AZ
Legal business name
WSG DENTAL DEVELOPMENT, LLC
Practice address
5577 N Oracle Rd Ste 101
Tucson, AZ 85704-3878
Phone
(520) 293-2267
Fax
(520) 293-4008
NPI assigned
Mar 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Ms. Fawne Pryor
Title
Ar and Insurance Manager
Phone
(602) 944-0073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D5988 AZ Primary

Addresses

Primary practice location

5577 N Oracle Rd Ste 101
Tucson, AZ 85704-3878

Mailing address

2323 W Mescal St Ste 205
Phoenix, AZ 85029-4764
Phone (602) 944-0073

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922123363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W MESCAL ST STE 205",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294764",
            "telephone_number": "602-944-0073",
            "fax_number": "602-944-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5577 N ORACLE RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043878",
            "telephone_number": "520-293-2267",
            "fax_number": "520-293-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WSG DENTAL DEVELOPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "FAWNE",
        "authorized_official_title_or_position": "AR AND INSURANCE MANAGER",
        "authorized_official_telephone_number": "602-944-0073",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, 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.