Casa Grande Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D05410 Issued in AZ

Legal business name

CASA GRANDE PEDIATRIC DENTISTRY

Practice address

1968 N Peart Rd Ste 19
Casa Grande, AZ 85122-2497

Phone

(520) 421-1400

Fax

(520) 421-1444

NPI assigned

May 13, 2013

Organization subpart

No

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

Authorized official

Name

Dr. James Johnson, DMDNPI 1881622165

Title

Member

Phone

(520) 421-1400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• James C Johnson, DMD

  • Pediatric Dentistry
  • Gilbert, AZ
  • NPI 1881622165
  NPD (past) Authorized official
• Blake Schow, DDS

  • Dentist
  • Gilbert, AZ
  • NPI 1568564201
  NPD (past)

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1932545456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 N PEART RD STE 19",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222497",
            "telephone_number": "520-421-1400",
            "fax_number": "520-421-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 N PEART RD STE 19",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222497",
            "telephone_number": "520-421-1400",
            "fax_number": "520-421-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA GRANDE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "520-421-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D05410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "587800",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casa Grande Impressions II, LLC (Impressions Dental)
• Casa Grande Internal Medicine PC
• Casa Grande Medical Supplies Inc
• Casa Grande Mobility (Mobility Plus of Casa Grande)
• Casa Grande Oral and Maxillofacial Surgery, P.C.
• Casa Grande Pediatrics
• Casa Grande Pharmacy Inc (Grand Pharmacy)
• Casa Grande Senior Living, LLC (Caliche Senior Living)
• Casa Grande Senior Living, LLC (Caliche Senior Living)
• Casa Grande Transportation Services, LLC

• Pediatric Dentistry in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.