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ARIZONA CENTER FOR IMPLANTS FACIAL AND ORAL SURGERY NPI 1063529394


NPI Information

NPI: 1063529394
Provider Name: ARIZONA CENTER FOR IMPLANTS, FACIAL, AND ORAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 03D1084762

Address:
18301 N 79TH AVE
SUITE G-185
GLENDALE, AZ
ZIP 85308
Phone: (623) 931-9197
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ARIZONA CENTER FOR IMPLANTS, FACIAL, AND ORAL SURGERY is an oral and maxillofacial surgery dentist in Glendale, AZ. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ARIZONA CENTER FOR IMPLANTS, FACIAL, AND ORAL SURGERY NPI is 1063529394. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

18301 N 79TH AVE
SUITE G-185
GLENDALE, AZ
ZIP 85308-463
Phone: (623) 931-9197
Fax: (623) 937-4385

The provider's authorized official is Gary K Lines .
The authorized official title is Partner and has the following contact phone number (623) 931-9197.

The CLIA number assigned to this NPI record is 03D1084762 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/24/2006 and was last updated on 8/22/2020.


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
11223S0112XDentistOral and Maxillofacial SurgeryYes

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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