STARLIGHT DENTAL SERVICES INC NPI 1063015576

NPI Information

NPI: 1063015576
Provider Name: STARLIGHT DENTAL SERVICES INC
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Organization
Address: 3440 W CACTUS RD STE 1
PHOENIX, AZ
ZIP 85029
Phone: (623) 688-3364

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NPI Details

STARLIGHT DENTAL SERVICES INC is a general practice dentist in Phoenix, AZ. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. STARLIGHT DENTAL SERVICES INC NPI is 1063015576. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3440 W CACTUS RD STE 1
PHOENIX, AZ
ZIP 85029-238
Phone: (623) 688-3364
Fax: (623) 244-0333

The provider's authorized official is Albert Tae .
The authorized official title is Ceo and has the following contact phone number (424) 392-2715.

The enumeration date for this NPI number is 11/17/2020 and was last updated on 4/23/2023.

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	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	No
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	No
3	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	No
4	124Q00000X	Dental Hygienist		No
5	126800000X	Dental Assistant		No
6	1223G0001X	Dentist	General Practice	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	2020P06513	OTHER	ARIZONA	ARIZONA DEPARTMENT OF PUBLIC SAFETY

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: 11/21/2025

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