PDA HOLDINGS LLC NPI 1134345937

NPI Information

NPI: 1134345937
Provider Name: PDA HOLDINGS, LLC

Doing Business As: MAGIC SMILES DENTAL CARE

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1701 E THOMAS RD #204
PHOENIX, AZ
ZIP 85016
Phone: (602) 253-6600
Get Directions

PDA HOLDINGS, LLC is a dental clinic center in Phoenix, AZ. PDA HOLDINGS, LLC NPI is 1134345937. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Magic Smiles Dental Care.

The provider's business location address is:

1701 E THOMAS RD #204
PHOENIX, AZ
ZIP 85016
Phone: (602) 253-6600
Fax: (602) 279-0821

The provider's authorized official is Amanda J Trujillo .
The authorized official title is Credentialing Manager and has the following contact phone number (602) 253-6600.

The enumeration date for this NPI number is 4/18/2007 and was last updated on 2/7/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry			No
2	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	232643	OTHER	ARIZONA	AHCCCS PROVIDER ID

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

NPI Synchronization or Removal

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