SEASONS SAGE NPI 1972085660

NPI Information

  • NPI: 1972085660
  • Provider Name: SEASONS SAGE
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: BRADSHAW FAMILY DENTAL
  • Address: 1260 S STATE ROUTE 89 STE G
    CHINO VALLEY, AZ
    ZIP 86323
  • Phone: (928) 237-1305

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NPI Details

SEASONS SAGE is a dental clinic center in Chino Valley, AZ. SEASONS SAGE NPI is 1972085660. The provider is registered as an organization entity type.
The provider Is Doing Business As Bradshaw Family Dental.

The provider's business location address is:

1260 S STATE ROUTE 89 STE G
CHINO VALLEY, AZ
ZIP 86323-624
Phone: (928) 237-1305
Fax: (928) 237-3038

The provider's authorized official is David Frausto .
The authorized official title is Owner and has the following contact phone number (928) 237-1305.

The enumeration date for this NPI number is 8/30/2018 and was last updated on 8/30/2018.

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/CenterDentalD5639ARIZONAYes

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
1722183MEDICAIDARIZONA

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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