NPIMap

Organization Active NPI

Coronado Dental Services, Inc.

  • Dentist
  • Chandler, AZ
National Provider Identifier
1932278025
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5032 Issued in AZ
Legal business name
CORONADO DENTAL SERVICES, INC.
Practice address
610 N Alma School Road
Suite 4
Chandler, AZ 85224-3687
Phone
(480) 461-8683
Fax
(480) 964-4171
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Phillip M Hendrix Jr., D.D.S.NPI 1801013586
Title
Doctor
Phone
(480) 461-8683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D5032 AZ Primary

Addresses

Primary practice location

610 N Alma School Road
Suite 4
Chandler, AZ 85224-3687

Mailing address

610 N Alma School Road
Suite 4
Chandler, AZ 85224-3687
Phone (480) 461-8683

Other identifiers 3

IdentifierTypeStateIssuer
188286MedicaidAZ
46654101MedicaidAZ
49124101MedicaidAZ

National Provider Directory

National Provider Directory

Locations

610 N Alma School Rd
Ste 4
Chandler, AZ 85224
Phone (480) 461-8683

Practitioners & affiliated clinicians

Practitioners 5

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": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1932278025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N ALMA SCHOOL ROAD",
            "address_2": "SUITE 4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243687",
            "telephone_number": "480-461-8683",
            "fax_number": "480-964-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N ALMA SCHOOL ROAD",
            "address_2": "SUITE 4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243687",
            "telephone_number": "480-461-8683",
            "fax_number": "480-964-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONADO DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-461-8683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188286",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46654101",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49124101",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.