NPIMap

Organization Active NPI

Tempe Modern Dentistry, LLP

  • General Practice Dentistry
  • Tempe, AZ
National Provider Identifier
1962703496
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TEMPE MODERN DENTISTRY, LLP
Practice address
1835 E Guadalupe Rd Ste C-107
Tempe, AZ 85283-3277
Phone
(480) 345-4017
Fax
(480) 345-3526
NPI assigned
Nov 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Dr. Ian D Young, DMD
Title
Owner
Phone
(480) 345-4017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1835 E Guadalupe Rd Ste C-107
Tempe, AZ 85283-3277

Mailing address

2860 Michelle FL 2
Irvine, CA 92606-1008
Phone (714) 368-2077

Other names 1

  • Tempe Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1835 E Guadalupe Rd
Ste C107
Tempe, AZ 85283
Phone (480) 345-4017

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1962703496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE FL 2",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061008",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 E GUADALUPE RD STE C-107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833277",
            "telephone_number": "480-345-4017",
            "fax_number": "480-345-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPE MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-345-4017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tempe Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.