NPIMap

Organization Active NPI

Anasazi Denture Clinic, LLC

  • Dental Clinic/Center
  • Rio Verde, AZ
National Provider Identifier
1962733600
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN60082396 Issued in WA
Legal business name
ANASAZI DENTURE CLINIC, LLC
Practice address
18425 E Stirrup LN
Rio Verde, AZ 85263-7114
Phone
(480) 471-9560
NPI assigned
Jan 20, 2010
Last updated
Jan 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Carmen Cain, CDT, LD, DN
Title
President
Phone
(480) 471-9560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN60082396 WA Primary
Exclusive Provider Organization 302F00000X DN60082396 WA

Addresses

Primary practice location

18425 E Stirrup LN
Rio Verde, AZ 85263-7114

Mailing address

P.O.Box 111
Dayton, WA 99328
Phone (480) 650-4234

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1962733600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 111",
            "city": "DAYTON",
            "state": "WA",
            "postal_code": "99328",
            "telephone_number": "480-650-4234",
            "fax_number": "480-471-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 E STIRRUP LN",
            "city": "RIO VERDE",
            "state": "AZ",
            "postal_code": "852637114",
            "telephone_number": "480-471-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANASAZI DENTURE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "CAIN",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-471-9560",
        "authorized_official_credential": "CDT, LD, DN"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DN60082396",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "WA",
            "license": "DN60082396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Verde, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.