NPIMap

Organization Active NPI

Arizona Mini Dental Implant Centers Mesa, LLC

  • Dentist
  • Mesa, AZ
National Provider Identifier
1942552104
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3008 Issued in AZ
Legal business name
ARIZONA MINI DENTAL IMPLANT CENTERS MESA, LLC
Practice address
633 N Gilbert Rd
Mesa, AZ 85203-6629
Phone
(480) 898-3053
Fax
(480) 656-4864
NPI assigned
Oct 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
Dr. Robert O Caseldine, DDS
Title
Owner
Phone
(480) 898-3053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3008 AZ Primary

Addresses

Primary practice location

633 N Gilbert Rd
Mesa, AZ 85203-6629

Mailing address

633 N Gilbert Rd
Mesa, AZ 85203-6629
Phone (480) 898-3053

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1942552104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 N GILBERT RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036629",
            "telephone_number": "480-898-3053",
            "fax_number": "480-656-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N GILBERT RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036629",
            "telephone_number": "480-898-3053",
            "fax_number": "480-656-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA MINI DENTAL IMPLANT CENTERS MESA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "CASELDINE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-898-3053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "3008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.