AZ RED MOUNTAIN PEDIATRIC DENTAL PLLC NPI 1679027817

NPI Information

NPI: 1679027817
Provider Name: AZ RED MOUNTAIN PEDIATRIC DENTAL PLLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
9101 E BROWN RD
102
MESA, AZ
ZIP 85207
Phone: (480) 565-8500
Get Directions

AZ RED MOUNTAIN PEDIATRIC DENTAL PLLC is a pediatric dentistry dentist in Mesa, AZ. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. AZ RED MOUNTAIN PEDIATRIC DENTAL PLLC NPI is 1679027817. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

9101 E BROWN RD
102
MESA, AZ
ZIP 85207-350
Phone: (480) 565-8500

The provider's authorized official is Jared W Welch .
The authorized official title is Owner and has the following contact phone number (480) 917-9339.

The enumeration date for this NPI number is 8/4/2016 and was last updated on 8/4/2016.

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	5685	ARIZONA	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	821497	MEDICAID	ARIZONA
2	914227	MEDICAID	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

NPI Synchronization or Removal

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