NPIMap

Organization Active NPI

Generation III Dental Incorporated

  • Dentist
  • Glendale, AZ
National Provider Identifier
1972925147
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D05984 Issued in AZ
Legal business name
GENERATION III DENTAL INCORPORATED
Practice address
16080 N 59TH Ave
Suite a
Glendale, AZ 85306-2339
Phone
(623) 398-6808
Fax
(623) 240-0683
NPI assigned
Jan 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Dr. Oksana Stoj, DMDNPI 1942387436
Title
Manager/Owner
Phone
(623) 398-6808

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D05984 AZ Primary

Addresses

Primary practice location

16080 N 59TH Ave
Suite a
Glendale, AZ 85306-2339

Mailing address

16080 N 59TH Ave
Suite a
Glendale, AZ 85306-2339
Phone (623) 398-6808

National Provider Directory

National Provider Directory

Locations

16080 N 59th Ave
Ste A
Glendale, AZ 85306
Phone (623) 398-6808

Practitioners & affiliated clinicians

Practitioners 1

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": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1972925147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16080 N 59TH AVE",
            "address_2": "SUITE A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853062339",
            "telephone_number": "623-398-6808",
            "fax_number": "623-240-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16080 N 59TH AVE",
            "address_2": "SUITE A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853062339",
            "telephone_number": "623-398-6808",
            "fax_number": "623-240-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATION III DENTAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "STOJ",
        "authorized_official_first_name": "OKSANA",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "623-398-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D05984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.