NPIMap

Organization Active NPI

Southern Dental LLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1952249195
Registry record updated Mar 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SOUTHERN DENTAL LLC
Practice address
3320 W Southern Ave Ste 111
Phoenix, AZ 85041-4307
Phone
(630) 699-3744
NPI assigned
Mar 21, 2026
Last updated
Mar 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2026

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

Authorized official

Name
Kendrick HolyoakNPI 1558891994
Title
Owner
Phone
(630) 699-3744

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary
Public Health Dentistry 1223D0001X NU
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU
Pediatric Dentistry 1223P0221X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

3320 W Southern Ave Ste 111
Phoenix, AZ 85041-4307

Mailing address

3934 E Austin Dr
Gilbert, AZ 85296-0711
Phone (602) 305-8800

National Provider Directory

National Provider Directory

Locations

3320 W Southern Ave
Ste 111
Phoenix, AZ 85041
Phone (602) 305-8800

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1774051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774051200000",
    "number": "1952249195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3934 E AUSTIN DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852960711",
            "telephone_number": "602-305-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 W SOUTHERN AVE STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414307",
            "telephone_number": "630-699-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-21",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A",
        "authorized_official_last_name": "HOLYOAK",
        "authorized_official_first_name": "KENDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-699-3744"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2026; 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.