TRI-STATES DENTAL INC. NPI 1649460221

NPI Information

  • NPI: 1649460221
  • Provider Name: TRI-STATES DENTAL, INC.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1518 SIERRA VISTA DR
    BULLHEAD CITY, AZ
    ZIP 86442
  • Phone: (928) 704-0144

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NPI Details

TRI-STATES DENTAL, INC. is a general practice dentist in Bullhead City, 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. TRI-STATES DENTAL, INC. NPI is 1649460221. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1518 SIERRA VISTA DR
BULLHEAD CITY, AZ
ZIP 86442-069
Phone: (928) 704-0144
Fax: (928) 704-9791

The provider's authorized official is Dominic Do .
The authorized official title is Cfo and has the following contact phone number (928) 704-0144.

The enumeration date for this NPI number is 7/30/2007 and was last updated on 7/30/2007.

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
11223G0001XDentistGeneral Practice4817NEVADAYes

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
1190343MEDICAIDARIZONA

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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