Just for Kids Dentistry Bullhead, PLLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

D6061 Issued in AZ

Legal business name

JUST FOR KIDS DENTISTRY BULLHEAD, PLLC

Practice address

2580 Hwy 95
Ste. 101
Bullhead City, AZ 86442

Phone

(928) 758-9464

Fax

(928) 758-9459

NPI assigned

Jun 27, 2008

Last updated

Mar 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ronald Anthony Dicarlo II, DMD

Title

President/Owner

Phone

(928) 718-7188

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Ryan Joseph Porter, DDS

  • General Practice Dentistry
  • Provo, UT
  • NPI 1083763668
  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1952563132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 HWY 95",
            "address_2": "STE. 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-758-9464",
            "fax_number": "928-758-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HWY 95",
            "address_2": "STE. 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-758-9464",
            "fax_number": "928-758-9459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST FOR KIDS DENTISTRY BULLHEAD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "DICARLO",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "928-718-7188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "AZ",
            "license": "D6061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "983470",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Jordan
• Joshua Springs Operations LLC
• Jr Renaissance Health Services
• Jr Renaissance Health Services, PLLC
• Just for Kids Dental Group Bullhead, PLLC (Just For Kids Dentistry)
• Ammar Kafa, M.D.
• Michael David Kantor, DDS
• Larry Joseph Keating, PAC
• Keith E. Boyd Jr DDS PC
• Violeta Andres Kelley, M.D.

• Exclusive Provider Organization in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Exclusive Provider Organization in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.