NPIMap

Organization Active NPI

Sun Life Family Health Center, Inc.

Doing business as Sun Life Pediatric Dentistry

  • Dental Clinic/Center
  • Casa Grande, AZ
National Provider Identifier
1992166359
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
BL-16-58324 Issued in AZ
Legal business name
SUN LIFE FAMILY HEALTH CENTER, INC.
Doing business as
Sun Life Pediatric Dentistry
Practice address
1864 E Florence Blvd
Suite1
Casa Grande, AZ 85122-5457
Phone
(520) 836-3446
Fax
(520) 836-8807
NPI assigned
Mar 14, 2016
Last updated
Aug 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Authorized official

Name
Travis J Robinette
Title
Chief Executive Officer
Phone
(520) 836-3446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X BL-16-58324 AZ Primary

Addresses

Primary practice location

1864 E Florence Blvd
Suite1
Casa Grande, AZ 85122-5457

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446

Other names 1

  • Sun Life Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
W Pinal Eloy Satellite15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 11

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": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1992166359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446",
            "fax_number": "520-836-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 E FLORENCE BLVD",
            "address_2": "SUITE1",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225457",
            "telephone_number": "520-836-3446",
            "fax_number": "520-836-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LIFE FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-14",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "ROBINETTE",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "520-836-3446"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "BL-16-58324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Life Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.