NPIMap

Organization Active NPI

Arizona Dental Affiliates, PLLC

Doing business as Wellness Dental Mesa

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1992428791
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARIZONA DENTAL AFFILIATES, PLLC
Doing business as
Wellness Dental Mesa
Practice address
1157 S Crismon Rd Ste 103
Mesa, AZ 85208-2661
Phone
(520) 376-8538
NPI assigned
Sep 26, 2022
Last updated
Sep 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Authorized official

Name
Sibera Troy Brannon, DDS
Title
Owner
Phone
(520) 376-8538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1157 S Crismon Rd Ste 103
Mesa, AZ 85208-2661

Mailing address

1157 S Crismon Rd Ste 103
Mesa, AZ 85208-2661
Phone (520) 376-8538

Other names 1

  • Wellness Dental Mesa Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arizona Dental Affiliates PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1992428791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 S CRISMON RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082661",
            "telephone_number": "520-376-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 S CRISMON RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082661",
            "telephone_number": "520-376-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DENTAL AFFILIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "SIBERA",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-376-8538",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Dental Mesa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.