Provider Type Icon

DESERT RIDGE PEDIATRIC DENTISTRY NPI 1811176860


NPI Information

NPI: 1811176860
Provider Name: DESERT RIDGE PEDIATRIC DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
5315 E. HIGH STREET
SUITE 115
PHOENIX, AZ
ZIP 85054
Phone: (480) 585-5868
Get Directions

DESERT RIDGE PEDIATRIC DENTISTRY is a dental clinic center in Phoenix, AZ. DESERT RIDGE PEDIATRIC DENTISTRY NPI is 1811176860. The provider is registered as an organization entity type.

The provider's business location address is:

5315 E. HIGH STREET
SUITE 115
PHOENIX, AZ
ZIP 85054
Phone: (480) 585-5868
Fax: (480) 585-1208

The provider's authorized official is Lidieth R Libby .
The authorized official title is Owner and has the following contact phone number (480) 585-5868.

The enumeration date for this NPI number is 10/26/2007 and was last updated on 7/17/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDental5548ARIZONAYes

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
1632481MEDICAIDARIZONA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.