Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm.
Organization Active NPI Dentist · Phoenix, AZ
NPI 1992819858 · NPPES record last updated Jul 1, 2026
Key facts
- NPI
- 1992819858
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM.
- Practice address
- 4212 N 16TH St
Phoenix, AZ 85016-5319 - Phone
- (602) 263-1200
- Fax
- (602) 263-1619
- NPI assigned
- Aug 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Authorized official
- Name
- Dr. Laura Tillman, MD
- Title
- Chief Medical Officer
- Phone
- (602) 263-1674
Corporate family (same tax ID) 17
National Provider Directory
- Tax ID family
- Phoenix Indian Med Cent
- Part of
- Phoenix Indian Med Cent
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | Yes | ||
| Public Health Dentistry |
1223D0001X | |||
| Endodontics |
1223E0200X | |||
| General Practice Dentistry |
1223G0001X | |||
| Pediatric Dentistry |
1223P0221X | |||
| Periodontics |
1223P0300X | |||
| Prosthodontics |
1223P0700X | |||
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | |||
| Dental Hygienist |
124Q00000X | |||
| Dental Assistant |
126800000X |
Addresses
Primary practice location
4212 N 16TH St
Phoenix, AZ 85016-5319
Mailing address
PO Box 95460
Cleveland, OH 44101-0033
Phone (602) 581-6076
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022062 | Medicaid | AZ | |
| P0206550 | Other | AZ | BCBSAZ |
| 092354 | Medicaid | AZ | |
| 418196 | Medicaid | AZ |
Other names
- IHS PHX MED CTR-DENTAL
- PIMC Dental Services
Other providers in Phoenix, AZ
- Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm
- Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm
- Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm
- Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm.
- Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm.
- Himmat Singh Dhillon
- Nitin Paul Dhiman
- Wandaliz Dhiman
- Guramritpal Singh Dhott
- DHS Automotive Group Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.