Surprise Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

D5002 Issued in AZ

Legal business name

SURPRISE DENTAL, LLC

Practice address

16630 W Greenway Rd
Suite 319
Surprise, AZ 85388-2185

Phone

(623) 582-9622

NPI assigned

Nov 11, 2008

Organization subpart

No

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

Authorized official

Name

Fawne E Pryor

Title

Office Manager

Phone

(623) 582-9622

Specialties & licenses 1

Addresses

Other names 1

• West Valley Family Dental Doing business as

Locations

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1942454483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16630 W GREENWAY RD",
            "address_2": "SUITE 319",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853882185",
            "telephone_number": "623-582-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16630 W GREENWAY RD",
            "address_2": "SUITE 319",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853882185",
            "telephone_number": "623-582-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "FAWNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "623-582-9622"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Valley Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Surprise Care PLLC
• Surprise Chiropractic Group, L.L.C.
• Surprise Comfort Home Care LLC
• Surprise Counseling
• Surprise Crossing Chiropractic, LLC
• Surprise Endo PLLC
• Surprise Endodontics
• Surprise Facility Group, LLC
• Surprise Family Dentistry
• Surprise Family Medicine PLC

• Dentist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.