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LYDIAN DENTAL QUEEN CREEK LLC NPI 1972097392


NPI Information

NPI: 1972097392
Provider Name: LYDIAN DENTAL QUEEN CREEK, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
21295 S ELLSWORTH LOOP RD STE 103
QUEEN CREEK, AZ
ZIP 85142
Phone: (480) 445-9188
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LYDIAN DENTAL QUEEN CREEK, LLC is a general practice dentist in Queen Creek, 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. LYDIAN DENTAL QUEEN CREEK, LLC NPI is 1972097392. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

21295 S ELLSWORTH LOOP RD STE 103
QUEEN CREEK, AZ
ZIP 85142-867
Phone: (480) 445-9188
Fax: (480) 526-8177

The provider's authorized official is Pam D Buckhanan .
The authorized official title is Insurance Coordinator and has the following contact phone number (480) 445-9188.

The enumeration date for this NPI number is 6/19/2018 and was last updated on 6/19/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeD009270ARIZONAYes

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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