NPIMap

Organization Active NPI

Ebw DMD PLLC

  • Dental Clinic/Center
  • Surprise, AZ
National Provider Identifier
1922594522
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8491 Issued in AZ
Legal business name
EBW DMD PLLC
Practice address
14800 W Mountain View Blvd Ste 200
Surprise, AZ 85374-2703
Phone
(623) 933-5749
NPI assigned
Jul 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Authorized official

Name
Dr. Eric Wendelschafer, DMD
Title
Dentist
Phone
(480) 606-2630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8491 AZ Primary

Addresses

Primary practice location

14800 W Mountain View Blvd Ste 200
Surprise, AZ 85374-2703

Mailing address

14800 W Mountain View Blvd Ste 200
Surprise, AZ 85374-2703
Phone (623) 933-5749

Other names 1

  • Great Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ebw DMD PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530835200000",
    "number": "1922594522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 W MOUNTAIN VIEW BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742703",
            "telephone_number": "623-933-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 W MOUNTAIN VIEW BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742703",
            "telephone_number": "623-933-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBW DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2018-07-06",
        "status": "A",
        "authorized_official_last_name": "WENDELSCHAFER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-606-2630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "8491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.