SAN TAN PEDIATRIC DENTAL NPI 1265625552

NPI Information

NPI: 1265625552
Provider Name: SAN TAN PEDIATRIC DENTAL
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
2510 E HUNT HWY
SUITE #29
QUEEN CREEK, AZ
ZIP 85243
Phone: (480) 457-1693
Get Directions

SAN TAN PEDIATRIC DENTAL is a pediatric dentistry dentist in Queen Creek, AZ. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SAN TAN PEDIATRIC DENTAL NPI is 1265625552. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2510 E HUNT HWY
SUITE #29
QUEEN CREEK, AZ
ZIP 85243-206
Phone: (480) 457-1693
Fax: (480) 457-1321

The provider's authorized official is Stephen J Montoya .
The authorized official title is Owner and has the following contact phone number (480) 457-1693.

The enumeration date for this NPI number is 8/21/2007 and was last updated on 10/9/2008.

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
1	1223P0221X	Dentist	Pediatric Dentistry	7384	ARIZONA	Yes

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
1	285009	MEDICAID	ARIZONA

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: 5/5/2024

NPI Synchronization or Removal

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