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ARROWHEAD LAKES DENTISTRY P C NPI 1154537884


NPI Information

NPI: 1154537884
Provider Name: ARROWHEAD LAKES DENTISTRY P C
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
20265 N 59TH AVE
SUITE B 5
GLENDALE, AZ
ZIP 85308
Phone: (623) 362-9616
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ARROWHEAD LAKES DENTISTRY P C is a general practice dentist in Glendale, 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. ARROWHEAD LAKES DENTISTRY P C NPI is 1154537884. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

20265 N 59TH AVE
SUITE B 5
GLENDALE, AZ
ZIP 85308
Phone: (623) 362-9616
Fax: (623) 362-2614

The provider's authorized official is Ronald K Shelley .
The authorized official title is Owner Doctor and has the following contact phone number (623) 362-9616.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 10/2/2012.


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
11223G0001XDentistGeneral Practice4433ARIZONANo
21223G0001XDentistGeneral Practice5928ARIZONANo
31223G0001XDentistGeneral Practice3505ARIZONAYes

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
16694270001MEDICARE NSCARIZONA

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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