EAST SCOTTSDALE PEDIATRIC DENTAL PC NPI 1073982997

NPI Information

NPI: 1073982997
Provider Name: EAST SCOTTSDALE PEDIATRIC DENTAL, PC

Doing Business As: DENTAL ASSOCIATES FOR KIDS ONLY

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

Specialization: Dental

Address:
12020 E SHEA BLVD
STE 8
SCOTTSDALE, AZ
ZIP 85259
Phone: (480) 767-5600
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EAST SCOTTSDALE PEDIATRIC DENTAL, PC is a dental clinic center in Scottsdale, AZ. EAST SCOTTSDALE PEDIATRIC DENTAL, PC NPI is 1073982997. The provider is registered as an organization entity type.
The provider Is Doing Business As Dental Associates For Kids Only.

The provider's business location address is:

12020 E SHEA BLVD
STE 8
SCOTTSDALE, AZ
ZIP 85259-179
Phone: (480) 767-5600

The provider's authorized official is Candace H Veneberg .
The authorized official title is Director and has the following contact phone number (501) 850-5110.

The enumeration date for this NPI number is 9/21/2015 and was last updated on 10/18/2015.

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	261QD0000X	Clinic/Center	Dental	D009209	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	064282	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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