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STEPHEN VITAL DMD INC NPI 1619134079


NPI Information

NPI: 1619134079
Provider Name: STEPHEN VITAL DMD INC
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
3505 E BROWN RD
SUITE 102
MESA, AZ
ZIP 85213
Phone: (480) 924-6169
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STEPHEN VITAL DMD INC is a preferred provider organization in Mesa, AZ. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. STEPHEN VITAL DMD INC NPI is 1619134079. The provider is registered as an organization entity type.

The provider's business location address is:

3505 E BROWN RD
SUITE 102
MESA, AZ
ZIP 85213-508
Phone: (480) 924-6169
Fax: (480) 924-1077

The provider's authorized official is Stephen J Vital .
The authorized official title is President and has the following contact phone number (480) 924-6169.

The enumeration date for this NPI number is 5/21/2008 and was last updated on 5/21/2008.


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
1305R00000XPreferred Provider Organization3270ARIZONAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13270OTHERARIZONASTATE OF ARIZONA

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

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