BISMARK LAKE LLC NPI 1285576058

NPI Information

  • NPI: 1285576058
  • Provider Name: BISMARK LAKE LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 14175 W INDIAN SCHOOL RD STE B6
    GOODYEAR, AZ
    ZIP 85395
  • Phone: (602) 902-0275

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NPI Details

BISMARK LAKE LLC is a dental clinic center in Goodyear, AZ. BISMARK LAKE LLC NPI is 1285576058. The provider is registered as an organization entity type.

The provider's business location address is:

14175 W INDIAN SCHOOL RD STE B6
GOODYEAR, AZ
ZIP 85395-490
Phone: (602) 902-0275

The provider's authorized official is Michael Hunt .
The authorized official title is Owner and has the following contact phone number (480) 280-4416.

The enumeration date for this NPI number is 4/8/2026 and was last updated on 4/8/2026.

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
1261QD0000XClinic/CenterDentalYes

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

NPI Synchronization or Removal

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