NPIMap

Organization Active NPI

Heartland Dental Care of Arizona, PC

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1992364319
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEARTLAND DENTAL CARE OF ARIZONA, PC
Practice address
4920 S Alma School Rd Ste 1
Chandler, AZ 85248-5547
Phone
(602) 612-9711
NPI assigned
Jun 10, 2019
Organization subpart
Yes
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4920 S Alma School Rd Ste 1
Chandler, AZ 85248-5547

Mailing address

4920 S Alma School Rd Ste 1
Chandler, AZ 85248-5547
Phone (807) 396-4044

Other names 1

  • Lakeside Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arizona Dental Professionals PC63 organizations share this tax ID, including this one
Part of
Arizona Dental Professionals PC

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1992364319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S ALMA SCHOOL RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852485547",
            "telephone_number": "807-396-4044",
            "fax_number": "480-590-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S ALMA SCHOOL RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852485547",
            "telephone_number": "602-612-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND DENTAL CARE OF ARIZONA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeside Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.