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GREENWAY DENTAL LAB INC. NPI 1053960500


NPI Information

NPI: 1053960500
Provider Name: GREENWAY DENTAL LAB INC.
Classification: Dental Laboratory Technician - 126900000X
Entity Type: Organization

CLIA Number: 03D2274300

Address:
1855 W GREENWAY RD STE 109
PHOENIX, AZ
ZIP 85023
Phone: (602) 242-2303
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GREENWAY DENTAL LAB INC. is a dental laboratory technician in Phoenix, AZ. The provider is an individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary. GREENWAY DENTAL LAB INC. NPI is 1053960500. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1855 W GREENWAY RD STE 109
PHOENIX, AZ
ZIP 85023-475
Phone: (602) 242-2303

The provider's authorized official is Matthew Frketich .
The authorized official title is Owner and has the following contact phone number (602) 242-2303.

The CLIA number assigned to this NPI record is 03D2274300 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2019 and was last updated on 9/7/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1126900000XDental Laboratory TechnicianYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.